A 22-year old graduate student was brought to the emergency department by university staff after he was found acting bizarrely. The man was staring into space and was not moving or interacting with others. This odd behavior continued in the emergency department. Upon arrival, the patient did not appear in any acute medical distress. In fact, his vital signs were completely unremarkable. The patient was connected to a cardiac monitor, and vascular access was established. The man's presentation was marked by immobility, staring, complete social withdrawal, and a significant decrease in verbal communication. Of particular interest was that he maintained his body in the exact position of his last movement (posturing). For instance, if the patient was asked to raise his arm, he maintained the arm in that position for an undetermined period. Another noteworthy feature was the man's lack of facial expression. Despite continued attempts to communicate with him, he had no facial expression, eye blinking, or any verbalization. He was able to follow commands if the same instructions were repeated two or three times.
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