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Images in Neurology
May 14, 2018

Osmotic Demyelination Syndrome With Evolving Movement Disorders

Author Affiliations
  • 1Division of Neurology and the Mah Pooi Soo and Tan Chin Nam Centre for Parkinson's and Related Disorders, University of Malaya, Kuala Lumpur, Malaysia
  • 2Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
JAMA Neurol. Published online May 14, 2018. doi:10.1001/jamaneurol.2018.0983

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.

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