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PubMed1985

Catatonia in the emergency department.

The catatonic syndrome has a wide differential diagnosis that includes both psychiatric and organic disorders. We present the cases of two patients with catatonia seen acutely in the emergency department. In these cases, the striking clinical picture proved to be secondary to psychiatric disturbances, and were accompanied by dementia in the second patient. The examining physicians were confused by the presentations, and the correct diagnosis and disposition were delayed. The clinical presentation of the catatonic complex, its differential diagnosis, and the pertinent physical signs are discussed.

Adult↗
PubMed1999

Frontal lobe psychopathology: mania, depression, confabulation, catatonia, perseveration, obsessive compulsions, and schizophrenia.

The frontal lobes can be subdivided into major functional neuroanatomical domains, which, when injured, surgically destroyed, or reduced in activity or volume, give rise to signature pathological and psychiatric symptomology. A review of case reports and over 50 years of research, including magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography scans, indicates that apathy, "blunted" schizophrenia, major depression, and aphasic-perseverative disturbance of speech and thought are associated with left lateral as well as bilateral frontal (and striatal) abnormalities. Impulsiveness, confabulatory verbosity, grandiosity, increased sexuality, and mania are associated with right frontal (as well as bilateral) disturbances. Gegenhalten, catatonia, and disturbances of "will" are indicative of medial frontal injuries. Disinhibitory states and obsessive-compulsive perseverative abnormalities are more frequently observed with orbital frontal lobe dysfunction, including frontal-striatal disturbances. These associations, however, are not always clear-cut as patients with the same diagnosis may demonstrate different symptoms that may be due to an additional abnormality in a different region of the brain. Moreover, as the frontal subdivisions are richly interconnected, and as frontal lobe abnormalities are not always discrete or well localized, a wide array of seemingly divergent waxing and waning symptoms may be manifest, sometimes simultaneously, including manic depression and what has been referred to as the "frontal lobe personality."

Bipolar Disorder↗
PubMedDate not supplied

Response of catatonia to risperidone: two case reports.

The present study describes two patients, both of Yemenite origin, with catatonic schizophrenia who responded to treatment with risperidone. One had a long history of psychiatric disorder, whereas the other was a first-episode, drug-naive patient. Our observation agrees with previous reports on the use of risperidone and other novel neuroleptic agents in the treatment of catatonia of different etiologies.

Adult↗
PubMed1995

Case study: ECT treatment of a young girl with catatonia.

This article reports a case of major depression with catatonic symptoms which occurred in an 8 1/2-year-old girl. While taking oral antidepressants, her symptoms worsened markedly, and significant physical morbidity appeared imminent. Electroconvulsive therapy was successful in treating the patient's catatonic and mood symptoms, with no observable deleterious effects. Review of the English-language literature reveals no younger patients ever reported to have presented with such severe catatonia or to have been treated with electroconvulsive therapy.

Catatonia↗
PubMed2005

PANDAS with catatonia: a case report. Therapeutic response to lorazepam and plasmapheresis.

This is a report of an 11-year-old, prepubertal boy with acute-onset urinary urgency and frequency, obsessions and compulsions related to urination, severe mood lability, inattention, impulsivity, hyperactivity, and intermittent periods of immobilization. Fever, cough, otitis, and sinusitis preceded neuropsychiatric symptoms. Antistreptolysin O and DNAse B antibody titers were elevated, and magnetic resonance imaging revealed bilateral diffuse caudate nuclei swelling. Plasmapheresis resulted in significant and rapid clinical improvement of obsessive-compulsive disorder symptoms and a simultaneous decrease in basal ganglia swelling, consistent with an immune-mediated pathophysiological process involving group A beta-hemolytic streptococci. Hyperactivity, impulsivity, and inattention improved with lorazepam, suggesting that the attention-deficit/hyperactivity disorder symptoms could be manifestations of catatonia.

Attention Deficit Disorder with Hyperactivity↗
PubMed1976

Lithium treatment of a patient with periodic catatonia.

This case report describes successful lithium treatment in a patient with long-standing periodic catatonia. Various medical treatments had been tried with meager results. Since 1955, a number of phenothiazines had been tried, also with little improvement. The institution of lithium treatment in 1964 caused a dramatic improvement in the patient's condition. For 9 years the patient remained totally asymptomatic. Lithium treatment was terminated in 1975 because of lithium intoxication with a diabetes insipidus-like syndrome. The patient then became psychotic again and has since experienced periodic phases similar to the previous illness. The diagnostic validity of the case is discussed, and some possible explanations of the favourable response to lithium are mentioned briefly.

Catatonia↗
PubMed1980

Catatonia with frontal lobe atrophy.

A middleaged woman with a four year history of behavioural change including episodes of catatonia is described. Despite a persistently abnormal electroencephalogram, the patient was diagnosed repeatedly as suffering from a primary psychiatric disorder. Neurological examination and psychological testing suggested frontal lobe dysfunction, which was confirmed by the finding of isolated frontal lobe atrophy on computed axial tomography.

Atrophy↗
PubMed1997

Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine.

Therapeutic efficiacy of the NMDA antagonist amantadine is reported in three acute neuroleptic free akinetic catatonic patients. Intravenous infusion of amantadine led to the resolution of catatonic symptoms and considerable reductions of scores in various motor scales (Simpson Angus scale for extrapyramidal side effects (SEPS), the abnormal involuntary movement scale (AIMS), Rogers catatonia and schizophrenia scales). The therapeutic effect of amantadine showed a characteristic temporal pattern with most pronounced effects four to six hours after administration and recurrence of catatonic symptoms by 24 hours later, at least partially. Such a temporal pattern of therapeutic efficacy and decreasing efficacy occurred in all three patients on all days. The results suggest the central importance of glutamatergic dysfunction in catatonic syndrome.

Adult↗
PubMed1990

Neuroleptic-induced catatonia or a mild form of neuroleptic malignant syndrome?

Neuroleptic-induced catatonia (NIC) and milder neuroleptic malignant syndrome (NMS) share parkinsonian features, catatonic symptoms, mild fever, and have been described in patients receiving antipsychotic agents. We report the case of a patient with a schizophreniform disorder and a mild mental retardation who developed a condition which can be diagnosed either as NIC or as a mild form of NMS and has been treated successfully with a combination of amantadine (600 mg/day) and diazepam (30 mg/day). The overlapping between NIC and mild NMS cases might lead to an overestimation of the incidence of current NMS and reinforces the view of the existence of a 'neuroleptic toxicity spectrum'.

Adult↗
PubMed1996

Schizophreniform catatonia on 6 cases secondary to hydrocephalus with subthalamic mesencephalic tumor associated with hypodopaminergia.

This paper presents 6 patients with catatonia and subthalamic mesencephalic tumors with hydrocephalus involving the third and the lateral ventricles. This anatomic and psychiatric anomaly is investigated on the basis of personal observations and a review of the literature. These cases allow an interesting parallel to be traced between neurological clinical signs and psychiatric signs. Various anatomic and physiological models are discussed which emphasize specialized neuronal circuits (somewhat similar to those involved in Parkinson's disease) and certain specific neurotransmitters such as dopamine, together with the reactivity of these circuits to intracranial pressure variations. Once more, clinical and laboratory data on schizophrenia concur to suggest that organic etiology is the causal factor in a known psychiatric pathology.

Adult↗
PubMed1977

Catatonia: prediction of response to somatic treatments.

The authors investigated predictors of somatic treatment response in 55 patients with one or more of eight catatonic motor features. Responders more often had good prognostic signs, rapid or pressured speech, and diagnosable affective disorder or alcoholism. Nonresponders were younger at age of onset of first illness and were more frequently disoriented; they included all patients diagnosed as schizophrenic. The authors suggest that treatment response in catatonia is a function of primary diagnosis and that the syndrome is diagnostically nonspecific but occurs most often in patients with affective disorders.

Adult↗
PubMed1985

Brainstem and vermis atrophy in catatonia.

The computerized tomographic scans of five catatonic patients and five matched controls were blindly assessed. The catatonic patients showed preponderant atrophy of the brainstem and cerebellar vermis. Catatonia may be associated with lesions in these areas.

Aged↗
PubMed1988

Carbamazepine in the treatment of catatonia.

Carbamazepine resolved within 6-24 hours the catatonic stupor in two patients, one with a schizophreniform and one with a schizoaffective disorder. Reports of frequent EEG abnormalities and the successful use of diazepam in catatonia prompted these trials with another anticonvulsant.

Adult↗
PubMed1984

Case report of conversion catatonia: indication for hypnosis.

The author describes the successful hypnotic treatment of a patient with an acute catatonic reaction. Because conversion mechanisms may underlie some presentations of catatonia, hypnosis may assist clinicians in the differential diagnosis of acute catatonic conditions.

Adult↗