This is such a great example of hyperreflexia + clonus from serotonin syndrome, seen a few of these in the hospital but never this pronounced.
#FOAMed

For my medical nerds, what’s the treatment for this?

Background:
Serotonin syndrome is a potentially life-threatening condition associated with increased serotonergic activity in the central nervous system (CNS). It is seen with therapeutic medication use, inadvertent interactions between drugs, and intentional self-poisoning.

Of note, the majority of cases of serotonin syndrome present within 24 hours, and most within six hours, of a change or initiation of a drug.
Typical vital sign abnormalities include tachycardia and hypertension, but severe cases may develop hyperthermia and rapid, dramatic swings in pulse and blood pressure.

Pertinent physical examination findings include: hyperthermia, agitation, ocular clonus, tremor, akathisia, deep tendon hyperreflexia, inducible or spontaneous clonus, muscle rigidity, dilated pupils, dry mucus membranes, increased bowel sounds, flushed skin, & diaphoresis. Neuromuscular findings are typically more pronounced in the lower extremities as seen here in this video.

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