A 63 years old man sustained a cut on his hand while gardening. He presents with signs of generalized muscle stiffness and trismus, and appears to be grimacing. Intermittent tonic contraction of his skeletal muscles causes intensely painful spasms, which last for minutes, during which he retains consciousness. During a generalized spasm the patient arches his back, extends his legs, flexes his arms in abduction, and, and clenches his fists. He also experiences dysphagia and apneic periods. Clinical exam reveals hyperpyrexia, cardiac arrhythmias, and hypotension. What are the most important differential diagnoses?

Of the relevant differential diagnoses, it is important to rule out meningitis and neuroleptic malignant syndrome.

Categorised in:

This post was written by Omar Rifai