Case 5: A 7-year-old autistic boy with altered movements and mental status

摘要

A 7-year-old boy with autism and attention-deficit/hyperactivity disorder transfers from an outside hospital adult emergency department to our inpatient unit for concerns of change in mental status for the past 2 days. His initial symptoms include sluggishness and disorientation, slowly progressing to drooling with forced jaw opening, gait abnormalities, left-sided truncal deviation, stiffness in extremities, broken speech, and body tremors. No history of fever, trauma, or ingestion of an unknown substance is identified on questioning. At baseline, the child is energetic, outspoken, and talkative.