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The patient was unresponsive to commands and unable to provide any history. In the ER he was given a provisional diagnosis of cerebrovascular accident (CVA). Vital signs on admission were stable. On physical examination, he exhibited grimacing, muscle rigidity and areflexia. Workup for CVA and infectious aetiology was unremarkable and the patient\u2019s urine toxicology screen was negative. History from the patient\u2019s family revealed that 4\u2009days prior to presentation, the patient had discontinued his prescribed dose of alprazolam 1\u2009mg four times per day. 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