Star Athlete With a Blinking Fixation Struggling in College

Claudia L. Reardon, MD


December 29, 2021

Physical Examination and Workup

The patient is 6 ft 4 in (193.04 cm) and weighs 200 lb (90.72 kg). His blood pressure is 121/68 mm Hg, pulse is 62 beats/min and regular, and respiration rate is 14 breaths/min. His temperature is 98.4 °F (36.9 °C).

The review of systems is entirely negative, and the results of the physical examination are normal.

On mental status examination, he is appropriately groomed and cooperative. He appears to blink repeatedly and somewhat forcefully, but no other abnormal movements are noted. The blinking occurs at irregular intervals. He has to ask the interviewer to repeat several questions. He fidgets with the strings on his sweatshirt. His affect is moderately anxious. His thought process appears linear, and there is no evidence of hallucinations, delusions, or suicidal or homicidal ideation. He is embarrassed to discuss these habits that help him "get through the day."

A urine toxicology screen is negative for marijuana, opiates, amphetamines, cocaine, benzodiazepines, and barbiturates. The results of a complete blood cell count, comprehensive metabolic panel, and thyroid panel are normal.


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