A 41-year-old man was admitted with acute parkinsonism, which deteriorated over the next few days to a state of akinetic mutism (Video 1, segment 1). He obeyed commands to move his eyes but was mute and did not blink, grimace, or move his limbs either to command or pain stimulation. There was resting tremor and severe rigidity involving all limbs. Plantar responses were downgoing. He required tube feeding and was fully dependent.
Tan AH, Lim S, Ng RX. Osmotic Demyelination Syndrome With Evolving Movement Disorders. JAMA Neurol. Published online May 14, 2018. doi:10.1001/jamaneurol.2018.0983
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