Clinical Vignette

58/Chinese/male, retired lorry driver

Married with 2 adult daughters 

Nil known allergies 

Medical History: 

(1) Depression

- treatment complicated by atypical drug-induced Parkinsonism vs ?catatonia (2013)

- MRI/MRA (Oct 2013) no masses, old left cerebellar infarct, mild proximal MCA irregularity

- EEG: normal awake and sleep EEG

- CSF: 43 RBC 1 WBC prot 0.34 gluc 3.8 

cultures neg, tetraplex neg

- autoimmune w/u: all negative

- malignancy/paraneoplastic screen: all negative

- improvement of symptoms with antidepressants (Mirtazapine), anti-psychotics (aripiprazole) and Madopar.