Which оf the fоllоwing would NOT аppeаr on а graphic slide?
Fоr the vignette, pleаse give а diаgnоsis and bullet pоint the symptoms that made you come to the diagnosis. A 5-year-old male was brought by his grandmother with a history of recurrent abnormal body movement and shaking of his body. It was initially misconstrued as a seizure without the loss of consciousness for 3 days. It was of abrupt onset and a fluctuating pattern. The client had no history of drug usage such as antipsychotic or antiemetic that could cause abnormal body movement. There were intervals of normal movement and behavior. He was said to be having 4–5 episodes of abnormal body movements per day. There was no history of muscle spasms or seizures at any time. There was no history of use of anticonvulsant at any time and EEG done was normal. The physical and neurological examination done on him was normal. His cognitive functions and psychometric evaluations were normal. Laboratory results, including a full blood count, blood film for the malaria parasite, and blood chemistry (serum calcium, sodium, potassium, and bicarbonate), were essentially normal. He was sleeping well and was fully interactive and energetic in the ward. The child was initially managed as a case of dystonia and placed on IV fluid and diazepam 2.5 mg twice daily for 2 days. On the 3rd day, repeated abnormal body movement persisted even while walking without any falls. Despite his age, this was odd because of abnormal movement and gyration while walking without any fall which is not consistent with features of seizure disorder or dystonia. The need to consider interaction with the child was encouraged to explore a positive outcome. The child was then instructed to display that movement voluntarily, and to our amazement, he was able to display the movement repeatedly and was able to abort the movement voluntarily. He was able to repeat this symptom and abort severely when instructed. Further history at this point revealed that the child and grandmother had frequented kind of syncretic churches where worshippers fall into a state of religious trance, during which they gyrate their bodies rhythmically while delivering “spiritual” messages. On close discussion with the child, he revealed his perceived passion for the body movement learned from the spirit-filled worshiper in the church and the attention he gets from the grandmother when displaying such movement. Adopting a nonjudgmental approach and gentle persuasion, the client was encouraged to tell the full story, and he expressed the passion he has for such movement and dance. He enjoyed mimicking the abnormal body movement because of the attention he got from his grandmother any time he displayed it.