R. Godfrey

T.P.26

McArdle disease is a rare condition and often people have had symptoms for many years before the diagnosis is made. There is no specific treatment for the condition but early diagnosis and appropriate management may improve exercise tolerance and prevent acute rhabdomyolysis. Here we present a patient with McArdle disease where an acute episode of neck muscle contracture causing nuchal rigidity was misdiagnosed as meningitis. The patient went onto develop an acute allergic reaction to systemic penicillin with potential life-threatening complications. The patient’s neck contracture was induced by dental extraction during which she was required to hold her mouth open and neck rigid for a prolonged time. This case illustrates that contracture in McArdle disease does not necessarily follow ’exercise’ and highlights the need for careful management during procedures.