Journal of Movement Disorders  2017;10(2):99-101

doi:10.14802/jmd.16058

Progressive Encephalomyelitis with Rigidity and Myoclonus in an Intellectually Disabled Patient Mimicking Neuroleptic Malignant Syndrome.

Zheyu XU 1 ; Kalpana PRASAD ; Tianrong YEO

Affiliations

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Keywords

Progressive encephalomyelitis with rigidity; neuroleptic malignant syndrome; autistic disorder

Country

Republic of Korea

Language

English

Abstract

We present a case of 32-year-old male with profound mental retardation and autism spectrum disorder who had presented with seizures, rigidity and elevated creatine kinase and was initially diagnosed as neuroleptic malignant syndrome (NMS). The patient subsequently had a complicated clinical course, developing refractory status epilepticus, which lead to the eventual diagnosis of progressive encephalomyelitis with rigidity and myoclonus (PERM). We discuss the clinical similarities and differences between NMS and PERM, and highlight the need to consider alternative diagnoses when the clinical picture of NMS is atypical, particularly in this patient group where the history and clinical examination may be challenging.