13 year old known case of AIP with recent onset of foul smell (olfactory hallucinations
) and stiffening (?catatonia).
AIP is a genetic disorder that can present with varied psychiatric symptoms. In these patients, the psychiatric symptoms (like hallucinations and catatonia) are usually seen along with the acute attacks, while in between attacks patients are normal and free of any psychiatric manifestations. Since you have seen her previous attacks, try to establish a relationship between the psychiatric symptoms and acute attacks. There can also be a chronic form of disorder where there is a background of few symptoms on top of which acute attacks occur intermittently. So in these cases it can be difficult to differentiate.
Either ways, the treatment for this symptom would be the same (apart from treatment and prevention of attacks). Many drugs are unsafe to give in these patients, Phenothiazine
groups of drugs are known to be safe in them.
Discuss this with an experienced paediatrician. He will be able to guide you.
Hope this helps,
Dr A Rao