Multiple neuromuscular abnormalities in a paranoid schizophrenic.

A broad range of skeletal muscle fiber abnormalities has been reported previously in muscle biopsy specimens from psychotic patients. In our experience, individual patients manifest only a few types of lesions; but we now have studied a paranoid schizophrenic patient whose skeletal muscle fibers show virtually the entire range of morphologic abnormalities. In addition to the morphologic abnormalities of skeletal muscle fibers, we also noted increased branching of subterminal motor nerves with enlarged endplates and chronic elevations of serum creatine phosphokinase activity. Despite this, the patient had minimal clinical evidence of neuromuscular dysfunction. The variety of types of neuromuscular dysfunctions found in this patient suggests their etiology may be related.