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PubMed1981

[The dominant inheritance of periodic catatonia].

In 143 patients suffering from periodic catatonia we found the disease in a direct succession five times in four generations and 17 times in three generations. With direct succession in four generations we found in two cases manifest psychosis in all generations, in three generations one member was formed by a most severely abnormal personality. In the sequence of three generations, the psychosis occurred continuously in ten families, in seven cases an abnormal personality pointed to the disease by his peculiarities. Since the occurrence of psychic diseases and abnormalities in the family is frequently concealed, the cases found are of great importance and indicate a dominant hereditary course. This assumption is substantiated by number of diseased half-brothers and sisters. Cataphasia in several generations in a direct sequence is a rarer phenomenon. Besides periodic catatonia, it showed the greatest affliction among the various forms of schizophrenia.

Adult↗
PubMedDate not supplied

[Diagnostic difficulties and efficacy of electroconvulsive therapy in the treatment of lethal catatonia].

This publication presents a case of 38-year old woman suffering from schizophrenia, whose body temperature reached 41 degrees C after she had taken 1250 mg of levomepromazine during a suicide attempt. Initially, the dominant symptoms were quantitative and qualitative disturbances of consciousness and periodically increased psychomotor activity, negativism, hallucinations, delusions, schizophrenic disturbances of affect became prominent. When the patient was hospitalized on the internal diseases ward, only symptomatic treatment was conducted, while the cause of the patient's high temperature was still investigated. Only when acute lethal catatonia was diagnosed and ECT was used, did the patient recover. In the event of rapid onset of high temperature in a patient with a mental disorder, a possibility of acute lethal catatonia must be always considered. A differential diagnosis of this disorder with neuroleptic malignant syndrome is very important, as the treatment is quite different. Many M.D.s aren't aware that high body temperature may be a symptom of a mental disease.

Adult↗
PubMedDate not supplied

[Structural disruption of the myelin sheaths in the CNS of adult rats with hereditary catatonia].

Ultrastructural studies have been made on the medio-dorsal region of n. caudatus and ventromedial part of the corpus callosum in rats with hereditary catatonia. In most of the nervous fibres, structural abnormalities were revealed in myelin sheaths. Dense myelin is split into several layers at the intraperiod line, terminal loops being swollen. Proliferation of oligodendroglia is also observed. Most of the mitochondria, both in the glia and nervous fibers, almost completely lack cristae. Proportional relationship between two main components of the cytoskeleton, i.e. neurofilaments and microtubuli, increases, which may be taken as an indication of a compensatory reaction. The observed morphological changes may play significant role in disturbances of sleep-wakefulness cycle in rats with hereditary catatonia.

Animals↗
PubMed1996

[The subjective experience in catatonia: systematic study of 24 catatonic patients].

Catatonic patients are often not able to communicate their subjective experiences behind their "fassade of immobility." Therefore was retrospectively (3 weeks later) investigated subjective experiences in 24 catatonic patients with a self-assessment-scale especially for catatonia developed by us. Our results showed that catatonic patients subjectively experience less their altered movements but rather cognitive, i.e. ambivalence, or affective, i.e. intense emotions which couldn't be controlled, alterations. According to our results we were able to distinguish an emotive (intense anxiety) from a non-emotive, i.e. cognitive (predominating ambivalence), subtype in catatonia with regard to subjective experience.

Adult↗
PubMed1996

ECT for lorazepam-refractory catatonia.

Catatonic syndromes are seen in diverse psychiatric and systemic illnesses, and may have varied presentations. Although reports suggest that benzodiazepines are helpful, debate persists regarding definitive treatment for catatonia. We present a case in which electroconvulsive therapy effectively resolved symptoms in an adolescent patient with catatonia who had only a transient response to lorazepam.

Adolescent↗
PubMed1997

[Acute life threatening catatonia--clinical significance and therapeutic possibilities].

Malignant catatonia, associated with different somatic and psychiatric disorders, is a rare, life-threatening syndrome. Immediate recognition and adequate treatment are essential and may be life-saving. We describe a case of malignant catatonia and discuss the clinical implications. Additionally, we review the recent literature regarding epidemiology, nosology, current pathophysiological concepts, differential diagnosis, and treatment recommendations.

Adult↗
PubMed1996

[Manneristic catatonia. A psychotropic drug refractory chronic progressive course].

Manneristic catatonia, one form of Leonhard's systematic schizophrenias, is illustrated in nine case notes. The essential syndrome of this rare disorder (described by Leonhard in the preneuroleptic era) consisted in mannerisms and progressive stiffness of psychomotor activity. Mannerisms often developed from obsessive and compulsive ideas; whereas distress disappeared, repetitive behavior developed into a stereotype. Complex movements (e.g. not to shake hands; mutism) became mannerisms. With disease progression stiffness of facial expression and gestures and an impairment of voluntary motor activity became increasingly prominent. There were no signs of (neuroleptic-induced) parkinsonism. Manneristic catatonia affects preponderantly men and exhibits an early age of onset (median: 23 years). In none of the cases a family history of psychiatric illness was noted. Severe obstetric and birth complications as well as the high prevalence of supratentorial and cerebellar CT/MR abnormalities in this patient group point to deviations of prenatal brain maturation. The median yearly dose of neuroleptics was 83.1 g chlorpromazin equivalents. The characteristic psychopathology was not essentially influenced by modern psychopharmacological treatment neither in the beginning nor in the long run irrespective of the time of onset of the disease. Continuous high-dose neuroleptic treatment is not efficacious in this distinct group of systematic schizophrenias. Behavioural training in a rehabilitation unit is the treatment of choice from the early beginning.

Adolescent↗
PubMed1985

[Dantrolene in the treatment of life-threatening psychiatric disease pictures. A contribution to the therapy of the malignant neuroleptic syndrome and acute febrile catatonia].

The malignant neuroleptic syndrome and acute febrile catatonia are life-threatening psychiatric disorders which frequently are treated in intensive care units outside psychiatric departments. Their manifestations are very similar to those of anaesthesia-specific malignant hyperthermia. The three syndromes have in common signs of increased muscle metabolism. Dantrolene, a specific drug in the treatment of malignant hyperthermia, has been used successfully several times recently in the treatment of the malignant neuroleptic syndrome. One such case is reported. In a 23-year-old man with signs of acute febrile catatonia parenteral dantrolene and electroconvulsive shocks succeeded in counteracting the symptoms of the abnormally raised muscle metabolism.

Adult↗
PubMed1992

Catatonia in a University Inpatient Service (1985-1990).

Catatonia is defined only as a subtype of schizophrenia in the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition (DSM-III) and DSM-III-revised (DSM-III-R), but catatonic symptoms are prominent in patients with psychoses, affective disorders, systemic illnesses, and neurotoxic states. We reviewed the case records of a 30-bed University Hospital adult inpatient psychiatric unit between 1985 and 1990, and identified 43 cases with admission or discharge diagnoses of schizophrenia, catatonic type (295.2). Of these, the records were adequate for detailed review in 19 cases. On discharge, seven were classified as schizophrenia, seven as affective disorder, and five as organic affective disorder. Eleven patients underwent electroconvulsive therapy (ECT), with excellent results in eight; 34 psychotropic medication trials were administered, with successful results in only two patients. Catatonia should be defined as a separate class in DSM-IV, thus encouraging the proper diagnosis and management of a treatable condition.

Journal Article↗
PubMed1989

'Catatonia' due to disulfiram toxicity.

In an alcoholic patient, catatonia developed while he was receiving disulfiram (Antabuse). Resolution of the question whether his state was classically catatonic required a detailed review of the literature on the subject. The conclusion reached is that the original definition still holds for psychiatric illness, but application of the term to neurological and metabolic states has often been based on imprecise criteria and failure to consider akinetic mutism and extrapyramidal motor disturbances as factors. The action of disulfiram as an inhibitor of dopamine beta hydroxylase provides a possible mechanism for the cerebral toxic effect, but nonetheless the various interpretations remain largely speculative.

Alcoholism↗
PubMed1977

Catatonia. Prevalence and importance in the manic phase of manic-depressive illness.

Of 123 acutely ill patients with bipolar affective disease, 28% exhibited clinical signs of catatonia. We were unable to differentiate manics with catatonic signs from manics without catatonic signs with regard to demographic characteristics, psychopathology, and the prevalence and pattern of psychiatric illness in their first-degree relatives. Our sample was similar to previously studied groups of manics. Although generally held to be associated with schizophrenia and of poor prognostic import, catatonic signs did not predict a poor treatment response in our manic patients. These data support the growing body of evidence demonstrating that catatonic signs are nonspecific and may be highly prevalent among patients with bipolar affective disease.

Adult↗
PubMedDate not supplied

Neuroleptic-induced catatonia after abrupt withdrawal of amantadine during neuroleptic therapy.

Catatonic reactions to high-potency neuroleptic drugs have been described in the literature. Our patient developed neuroleptic-induced catatonia (NIC) after abrupt withdrawal of amantadine, a dopaminergic agent that has been implicated in neuroleptic malignant syndrome (NMS) on its discontinuation. This case report adds support to the hypothesis that NIC and NMS are 2 syndromes on a continuum of dopamine blockade, each of which may be treated with or uncovered by amantadine therapy.

Adolescent↗
PubMed2006

Correlated activity of sensorimotor cortex neurons in the left and right hemispheres of the rabbit brain in immobilization catatonia.

Spike sequences extracted from multineuron activity from neurons in the sensorimotor cortex, and recorded simultaneously in the left and right hemispheres of the brains of rabbits in the state of immobilization catatonia ("animal hypnosis") and on recovery of animals from this state were analyzed. Cross-correlation analysis of spike flows revealed a temporal relationship between the appearance of neuron spikes in the left and right hemispheres; these were regarded as the mutual influences of these neurons on each other. The intensity of the influences of left hemisphere neurons on cells in the right brain was shown to change significantly in relation to baseline measures at all stages of the experiment and at all of the time points studied. The intensity of the influences of neurons in the right hemisphere on cells in the left hemisphere changed significantly only after animals recovered from the state of immobilization and over much more restricted time periods.

Action Potentials↗
PubMed1984

Bremazocine induces antinociception, but prevents opioid-induced constipation and catatonia in rats and precipitates withdrawal in morphine-dependent rats.

Some in vivo agonist and antagonist properties of the putative k-compound bremazocine were characterized in rats. Bremazocine, at doses from 0.015-32 mg/kg i.p., delayed nociceptive reaction on a 55 degrees C hot-plate with a dose-response curve not readily fitting a single straight line; this effect was antagonized by high doses of naloxone. In the same rats bremazocine did not delay the intestinal transit of a charcoal meal fed 5 min earlier and prevented morphine-induced constipation. This antagonism appeared to be opioid-specific and competitive, with apparent pA2 value 8.56. Catatonia induced by etorphine (0.004 mg/kg s.c.) and constipation induced by etorphine (0.004 mg/kg s.c.) and D-Ala2-D-Leu5-enkephalin (0.1 mg/kg i.p.) were completely antagonized by bremazocine (0.03-8 mg/kg i.p.). Antinociception induced by morphine (10 mg/kg i.v.) and etorphine (0.004 mg/kg s.c.) was only partly prevented. Naloxone (1 mg/kg) and bremazocine (0.015-1 mg/kg i.p.) precipitated a withdrawal syndrome, evaluated as jumping frequency, in rats rendered dependent to morphine. These data suggest the involvement of more than one opioid receptor population in bremazocine action in vivo.

Analgesics↗
PubMed1990

Neuroleptic-induced catatonia: neuroleptic malignant syndrome?

1. The authors describe a case report of catatonia syndrome after administration of depot neuroleptics. 2. Differential diagnosis was made between neuroleptic malignant syndrome or catatonic syndrome complicated by infection. The signs and symptoms observed throughout the patient's course are detailed. 3. A critical review is made of bibliography on the topic, with emphasis on the lack of clear clinical description and poor conceptual definition.

Adult↗
PubMedDate not supplied

Pregnancy and malignant catatonia.

The occurrence of malignant catatonia in pregnancy is a psychiatric emergency. In this article, we present the case of a pregnant woman with a first psychotic episode with catatonic features, autonomic abnormalities and elevated creatinine phosphokinase levels in the context of a severe adverse reaction to antipsychotic pharmacotherapy who had good responses to electroconvulsive therapy and lorazepam.

Adult↗
PubMed2005

No causative DLL4 mutations in periodic catatonia patients from 15q15 linked families.

Two well-supported theories of schizophrenia pathogenesis are the neurotransmitter theory and the neurodevelopmental theory, suggesting, respectively, that dysregulation of neurotransmitter signaling and abnormal brain development are causative in this disease. The strongest evidence of neurotransmitter involvement are suggestions of abnormal dopamine signaling in the prefrontal cortex and one of the strongest indications of developmental abnormalities contributing to this disease is an inverse layering of the prefrontal cortex. These two theories of schizophrenia pathogenesis can be united by their involvement of the prefrontal cortex, where structural abnormalities could lead to neurochemical abnormalities. Accordingly, any gene expressed in the prefrontal cortex of developing brains is a functional candidate for schizophrenia. We have previously reported strong linkage to 15q15 (LOD = 3. 57; P = 2.6 x 10(-5)) in a collection of German multiplex families segregating the periodic catatonia subtype of schizophrenia in a nearly Mendelian fashion. A gene within our 15q15 linkage region, DLL4, is expressed in developing forebrain and produces a NOTCH4 ligand. Variants of NOTCH4 are associated with schizophrenia, thus DLL4 is both a functional as well as a positional candidate for schizophrenia. We screened this gene for mutations in three affected individuals and two unrelated controls and found two previously unreported SNPs, one non-synonymous polymorphism that changed an arganine to a histadine in Exon 7 and one synonymous polymorphism in exons. The non-synonymous SNP is a rare variant in that it was not found in 100 control chromosomes; however, it did not cosegregate with the disease in the extended family so it is not causative in this pedigree. It is unlikely that mutations in DLL4 are causative in this collection of families with linkage to 15q15.

Adaptor Proteins, Signal Transducing↗
PubMed1994

Electrocardiographic and echocardiographic changes associated with malignant catatonia.

We describe a case of malignant catatonia manifested by catatonic symptoms, fever, hemodynamic instability, and acute neurologic decline that was associated with electrocardiographic and echocardiographic abnormalities similar to those noted in patients with other central nervous system processes. The patient's electrocardiographic and echocardiographic abnormalities resolved after successful electroconvulsive therapy for the underlying neuropsychiatric disorder. The theoretic, physiologic, and clinical significances of this case are discussed.

Aged↗