Editor's Note:

The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians, but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please email us at [email protected] with the subject line "Case Challenge Suggestion." We look forward to hearing from you.

A 70-year-old White male veteran presents to the outpatient mental health clinic at a Veterans Health Administration facility with a chief complaint of short-lived muscle spasms which are causing abnormal posture and movement. He experiences some distress from these symptoms. The patient came in by himself because of the ongoing impairment he has been experiencing from the ongoing flexion of his body and head to one side.