psychiatry neurology

Abnormal Involuntary Movement Scale (AIMS)

Clinician-rated 12-item scale for assessing tardive dyskinesia and other abnormal involuntary movements in patients on antipsychotic medications. Items 1–7 are scored 0–4; items 8–12 are additional assessments.

Facial muscles (muscles of facial expression)*

Lips and perioral area (puckering, pouting, smacking)*

Jaw (biting, clenching, chewing, lateral movement)*

Tongue (rate only increases in movement both in and out of mouth)*

Upper extremities (arms, wrists, hands, fingers — not include tremor)*

Lower extremities (legs, knees, ankles, toes)*

Trunk (neck, shoulders, hips)*

Score interpretation

No Significant Dyskinesia 0–1

AIMS 0–1 — no clinically significant abnormal movements

→ Continue current antipsychotic with regular monitoring (every 3–6 months); document baseline for future comparison

Mild Tardive Dyskinesia 2–7

AIMS 2–7 — mild TD; at least one item ≥2

→ Review antipsychotic; consider dose reduction or switching to clozapine or quetiapine; discuss with patient/carer; consider valbenazine or deutetrabenazine; repeat AIMS in 3 months

Moderate-Severe Tardive Dyskinesia 8–28

AIMS ≥8 — moderate to severe tardive dyskinesia

→ Urgent psychiatry review; strongly consider switching antipsychotic; valbenazine (40–80 mg daily) or deutetrabenazine (VMAT2 inhibitors) approved for TD; clonazepam as adjunct; functional impact assessment

Interpretation bands for the AIMS. Apply clinical judgement and local guidance.

References

Guy W. ECDEU Assessment Manual for Psychopharmacology (Revised). National Institute of Mental Health. 1976.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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