Unrecognized Postoperative Opioid-Induced Movement Disorder: A Case Report

Area of Science:

• Anesthesiology
• Neurology
• Pain Management

Background:

• A 22-year-old male with a history of posttraumatic stress disorder and chronic pain underwent ankle surgery.
• The patient developed episodic muscle rigidity in the immediate postoperative period.

Observation:

• The patient's symptoms necessitated admission for diagnostic evaluation.
• A broad differential diagnosis was considered, including local anesthetic toxicity, medication effects, seizures, serotonin syndrome, and malignant hyperthermia.

Findings:

• Cultural and systemic differences in healthcare delivery at a Japanese hospital were crucial in elucidating the mechanism of the patient's condition.
• The case highlights the importance of considering cultural factors in pain management and differential diagnosis.

Implications:

• This case underscores the need for comprehensive differential diagnosis of acute onset movement disorders in the postoperative setting.
• It emphasizes the impact of cultural and systemic variations on patient care and diagnostic processes.