Approach to medication-induced movement disorders Quiz: Ace Your Exams
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A 26-year-old man is brought to the emergency department by ambulance after he was found confused and distressed in a local park, prompting bystanders to call for help. The patient is unable to provide a medical history. A pharmacy dispense report available on the electronic health record shows a recent prescription for pimozide was issued three weeks prior to presentation. Pulse is 102/min, respirations are 22/minute, blood pressure is 142/82 mmHg, and oxygen saturation is 96% on room air. On physical examination, the patient opens his eyes to stimuli and mumbles incoherently. His clothing is soiled with urine. The airway is stable. Musculoskeletal examination is notable for diffuse muscle rigidity. Laboratory results are shown below. Brain imaging, lumbar puncture, and initial infection evaluations are negative. A toxicology screen is negative for recreational substances. Which of the following additional findings would support a diagnosis of a medication side effect?
| Laboratory Value | Result |
| Glucose, CSF | 40 mg/dL |
| Creatine Kinase | 8271 U/L |
| Bilirubin, Total | 0.9 mg/dL |
| Bilirubin, Direct | 0.2 mg/dL |
| Creatinine | 4.0 mg/dL |
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