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CASE REPORT
Muscle spasm-induced exothermia in dystonic cerebral palsy: uncommon and frequently misdiagnosed condition
  1. Paolo Nikolai Hao So1,
  2. Maria Ruby Rose Quijano Castañeda2,
  3. Anne Rolaine Velasco Morante3 and
  4. Raymond Villacorta Oliva4
  1. 1 Department of Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines
  2. 2 Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
  3. 3 Department of Family and Community Medicine, University of the Philippines - Philippine General Hospital, Manila, Philippines
  4. 4 Department of Medicine, Section of Hypertension, University of the Philippines - Philippine General Hospital, Manila, Philippines
  1. Correspondence to Dr Paolo Nikolai Hao So, paolonikolaiso{at}gmail.com

Abstract

A known cerebral palsy young man presented with prolonged bouts of generalised body movements associated with high-grade fever without any localising signs of infection, requiring multiple hospital admissions over several months. All septic work-ups, including a lumbar puncture, were negative. Serum chemistry was consistent with rhabdomyolysis. Repeated electroencephalograms showed no epileptiform discharges. Cranial MRI with gadolinium contrast revealed left cerebral atrophy with hyperintensities at the left basal ganglia. Uncontrolled dystonia with concomitant rhabdomyolysis was considered. Subsequent aggressive hydration and administration of muscle relaxant afforded abrupt resolution of symptoms.

  • cerebral palsy
  • neurology
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Footnotes

  • Contributors PNHS conceptualised and wrote the initial manuscript, collaborated with all co-authors and proofread all parts of the article. MRRQC reviewed the patient’s neurological diagnostics and contributed on the discussion of seizures and dyskinetic CP. ARVM helped in video-taping the patient’s symptomatology with due consent from the relatives, and in reviewing journals on rhabdomyolysis and dystonia. RVO contributed to the writing, reviewing, validating and finalisation of the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin obtained.

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