Table 1.
Entity | Age | Trigger | Time course | Movement disorder phenomenology | Other neuro signs | Altered mental status | Autonomic instability |
---|---|---|---|---|---|---|---|
Dystonic storm | P | +/− | Hours-Days | Dystonia +/− chorea | − | − | + |
Choreic storm | P-YA | +/− | Hours-Days | Chorea | − | − | − |
Oculogyric crisis | All | +++ | Acute | Dystonia | Oculogyria | − | +/− |
Neuroleptic malignant syndrome | A | +++ | Days-Weeks | Parkinsonism | − | + | + |
Serotonin syndrome | All | +++ | Hours-Days | Myoclonus | − | + | + |
Lethal catatonia | All | +/− | Hours-Days | Parkinsonism | − | + | + |
Malignant hyperthermia | All | +++ | Acute | − | − | − | − |
Drug intoxication | All | +++ | Acute | − | Psychosis | + | +/− |
Intrathecal baclofen withdrawal | P-YA | +++ | Acute-Hours | − | − | + | + |
Delirium tremens | A | +++ | Acute | Myoclonus | Psychosis | + | + |
Autoimmune encephalitis (e.g. anti-NMDA) | P-YA | − | Days-Weeks | Chorea | Psychosis | + | + |
This table provides the list of differential diagnosis of dystonic storm. Useful distinguishing features include age group (pediatric, young adult, adult and all), presence or absence of triggering factors (number of “+” sign correlates with stronger relationship; “+/−” represents inconsistent correlation; “−” represents no correlation), time course, movement disorder phenomenology, associated neurological signs, altered mental status and autonomic instability
Abbreviations: P pediatric, YA young adults, A adults, All all age groups