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An adult male presented with repeated episodes of hyperkinetic behavior lasting more than 5 minutes and resulting in running around and slamming into objects in his way. Multiple collusions with walls, bedframes and other objects led to a variety of lesions in various stages of healing all over his head and body. Most of these episodes were of relatively short duration and the patient would either receive an intra-muscular injection to calm him down or he would fall asleep from exhaustion. He functioned in the below average range of intellect and had a long history of substance use disorder since the early teenage years. Substances used at a regular basis included cocaine, crack cocaine, marijuana and alcohol. He had a documented previous history of seizures and cerebral atrophy.