Abnormal Involuntary Movement Scale

Before or after completing the scoring, clinicians should do the following:

1. Observe patient's gait on the way into the room.

2. Have patient remove gum or dentures if ill-fitting.

3. Determine whether patient is aware of any movements.

4. Have patient sit on a firm, armless chair with hands on knees, legs slightly apart, and feet flat on the floor. Now and throughout the examination, look at the entire body for movements.

5. Have patient sit with hands unsupported, dangling over the knees.

6. Ask patient to open mouth twice. Look for tongue movements.

7. Ask patient to stick out the tongue twice.

8. Ask patient to tap thumb against each finger for 15 seconds with each hand. Observe face and legs.

9. Have patient stand with arms extended forward.

Rate each of the following items on a 0 to 4 scale for the greatest severity observed:

1. 0 = none

2. 1 = minimal, may be extreme normal

3. 2 =mild

4. 3 = moderate

5. 4 = severe

Movements that occur only on activation are given 1 point less than those that occur spontaneously.

Category

Item

Range of Possible Scores

Facial and oral movements

Muscles of facial expression

0 1 2 3 4

Lips and perioral area

0 1 2 3 4

Jaw

0 1 2 3 4

Tongue

0 1 2 3 4

Extremity movements

Arms

0 1 2 3 4

Legs

0 1 2 3 4

Trunk movements

Neck, shoulders, and hips

0 1 2 3 4

Global judgment

Severity of abnormal movements

0 1 2 3 4

Incapacitation due to abnormal movements

0 1 2 3 4

Patient’s awareness of abnormal movements (0 = unaware; 4 = severe distress)

0 1 2 3 4