Crowned Dens Syndrome Presenting as Altered Mental Status

A 77-year-old male presented from a rehabilitation facility for acute onset of confusion, significant pain in his neck and extremities, muscle rigidity and subjective fever. Co-morbidities included Parkinson's disease, Lewy Body Dementia, anxiety, depression and recent right shoulder surgery complicated by pulmonary embolism, for which he was started on Eliquis. On admission, physical exam revealed severely limited range of motion in neck, diffuse rigidity and weakness in all extremities, diffuse joint pain with movement of extremities and neck, and disorientation.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research