A 24 year-old woman was admitted to the a psychiatric ward with a 2 week history of thought disorder. She had become suspicious of her family, thinking they were trying to poison her. On admission her neurological examination was otherwise normal. There is no relevant family history except for an episode of depression while she was at University.
She was treated with antipsychotic agents with some response but then developed a generalised tonic-clonic seizure. Ten hours after the seizure she is confused, sweaty and tachycardic (HR 130). She exhibits waxy flexibility, a staring expression and adopts a dystonic posture of her left arm.
How would you proceed further?
Thanks to Dr David Hunt again for this week’s case.