Nielsen syndrome (exhaustive psychosis syndrome; neuromuscular exhaustion syndrome) 8

General: Chronic infections; postoperative phases frequently 636e44g are associated with extreme stress and fatigue; similar manifestations often have been reported during and after prolonged combat; develops subacutely after severe overexertion during a period of euphoria.

Ocular: Paralysis of extraocular muscles; diplopia.

Clinical: Physical exhaustion; extreme weakness; delirium; fascicular twitching; poor attention; restlessness; lack of concentration; irritability; depression; anxiety; pain in muscles; weight loss; muscle flaccidity; absence of deep reflexes.

Nielsen JM. Subacute generalized neuromuscular exhaustion syndrome. Bull Los Angeles Neurol Soc 1940; 5:128, and Calif Med

Strassman HD, et al. A prisoner of war syndrome: apathy as a reaction of severe stress. Am J Psychiatry 1956; 112:998.