Muscle spasm-induced exothermia in dystonic cerebral palsy: uncommon and frequently misdiagnosed condition

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.