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The most pathognomonic symptom of myofascial pain syndrome is the presence of pressure-sensitive palpable nodules that reproduce the chief complaint: they are called trigger points.
The pathognomonic symptom of the menopause is the hot flush, a sudden explosive physiologic phenomenon that lasts for about 4 minutes and usually occurs several times a day, most frequently during sleep.
In this case the patient had pathognomonic symptoms of CS, so it was relatively easy to make the diagnosis; but acute psychotic symptoms in CS can be life-threatening and may not be associated with the typical physical symptoms of CS (if there is only modest hypercortisolemia), so psychiatric clinicians should always consider CS among the possible differential diagnoses for unexplained acute psychosis.