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We present the case of a middle-aged man with a chronic history of schizoaffective disorder, depressed type, stable on a second-generation antipsychotic. Psychotic symptoms recurred contingent to medication noncompliance necessitating hospitalization. Treatment was complicated by the development of neuroleptic malignant syndrome (NMS). In addition, subsequent medication rechallenges failed because of recurrent rhabdomyolysis and atypical NMS. Electroconvulsive therapy (ECT) treatment was initiated, affording remission of psychotic symptoms and nonrecurrence of NMS and rhabdomyolysis. Our experience confirmed the efficacy of ECT treatment in providing symptom relief of psychosis complicated by recurrent episodes of NMS and atypical NMS. Likewise, it illustrated the efficacy of ECT treatment for rhabdomyolysis.

Anorexia nervosa is a syndrome characterized by severe weight loss and preoccupation of distorted body image with resulting complications due to starvation. In most of the typical cases of anorexia nervosa, neuroimaging is not done. However, with increasing evidence of intracranial lesions associated with eating disorders including anorexia nervosa, neuroimaging is indicated in almost all cases. We present a case of a 17-year-old female who was admitted initially with the diagnosis of anorexia nervosa (restricting type) and later found to have pituitary adenoma.