CASE PRESENTATION: A 73-year-old Caucasian woman with no history of neuromuscular disorder, treated for chronic
delusional disorder for the last ten years, received two
injections of long-acting
haloperidol. She was then referred for
fatigue. Physical examination showed a frank
parkinsonism without other abnormalities. Routine laboratory tests showed normal results, notably concerning
creatine kinase level.
Fatigue was attributed to
haloperidol which was substituted for
olanzapine. Our patient left the hospital after five days without complaint. She was admitted again three days later with acute
back pain. Examination showed
camptocormia and tenderness in paraspinal muscles.
Creatine kinase level was elevated (2986 UI/L). Magnetic resonance imaging showed
necrosis and
edema in paraspinal muscles.
Olanzapine was discontinued.
Pain resolved quickly and muscle
enzymes were normalized within ten days.
Risperidone was later introduced without significant side-effect. The camptocormic posture had disappeared when the patient was seen as an out-patient one year later.
CONCLUSIONS: