Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report

Introduction Catatonia due to cerebrovascular stroke is a rare condition that needs further observation and research. Objectives To review the opinions of psychotic disorders experts worldwide as to this issue based on evidence and clinical experience and to consider strategies for future investiga...

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Main Authors: H. Hasan, M. Abdo, S. Rabei
Format: Article
Language:English
Published: Cambridge University Press 2023-03-01
Series:European Psychiatry
Online Access:https://www.cambridge.org/core/product/identifier/S0924933823022459/type/journal_article
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author H. Hasan
M. Abdo
S. Rabei
author_facet H. Hasan
M. Abdo
S. Rabei
author_sort H. Hasan
collection DOAJ
description Introduction Catatonia due to cerebrovascular stroke is a rare condition that needs further observation and research. Objectives To review the opinions of psychotic disorders experts worldwide as to this issue based on evidence and clinical experience and to consider strategies for future investigations. Methods This case shows a 64 years old female who suddenly developed wish for isolation, followed 10 days later by discontinuity of ideas, hallucinatory behavior and food refusal. She had verbal and physical aggression due to a fixed belief that family members are conspiring somehow to harm her. Results On examination she was mute with waxy flexibility and negativism. Extensor plantar reflex was evident. MRI Brain showed small vessel disease and right basal ganglia acute ischemic infarction. On IV midazolam 7.5 mg, patient’s mutism, negativism and waxy flexibility improved. Lower limb Venous Duplex revealed acute right popliteal and left soleal veins thrombosis. CT angiography showed Bilateral pulmonary embolism with no pulmonary infarction. D dimer was positive. Conclusions Early diagnosis and intervention improves outcome if psychiatric teams gives attention and has enough awareness with warning symptoms and prompt necessary interventions. Disclosure of Interest None Declared
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spelling doaj.art-b09130ed02fb4e28872f69ad530771bc2023-11-17T05:09:25ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S1058S105810.1192/j.eurpsy.2023.2245Post Cerebrovascular Stroke Catatonic Psychosis: A Case ReportH. Hasan0M. Abdo1S. Rabei2Neuropsychiatry, Helwan University - Faculty of MedicinePsychological Medicine Hospital, Cairo, EgyptNeuropsychiatry, Helwan University - Faculty of Medicine Introduction Catatonia due to cerebrovascular stroke is a rare condition that needs further observation and research. Objectives To review the opinions of psychotic disorders experts worldwide as to this issue based on evidence and clinical experience and to consider strategies for future investigations. Methods This case shows a 64 years old female who suddenly developed wish for isolation, followed 10 days later by discontinuity of ideas, hallucinatory behavior and food refusal. She had verbal and physical aggression due to a fixed belief that family members are conspiring somehow to harm her. Results On examination she was mute with waxy flexibility and negativism. Extensor plantar reflex was evident. MRI Brain showed small vessel disease and right basal ganglia acute ischemic infarction. On IV midazolam 7.5 mg, patient’s mutism, negativism and waxy flexibility improved. Lower limb Venous Duplex revealed acute right popliteal and left soleal veins thrombosis. CT angiography showed Bilateral pulmonary embolism with no pulmonary infarction. D dimer was positive. Conclusions Early diagnosis and intervention improves outcome if psychiatric teams gives attention and has enough awareness with warning symptoms and prompt necessary interventions. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823022459/type/journal_article
spellingShingle H. Hasan
M. Abdo
S. Rabei
Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
European Psychiatry
title Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
title_full Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
title_fullStr Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
title_full_unstemmed Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
title_short Post Cerebrovascular Stroke Catatonic Psychosis: A Case Report
title_sort post cerebrovascular stroke catatonic psychosis a case report
url https://www.cambridge.org/core/product/identifier/S0924933823022459/type/journal_article
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AT mabdo postcerebrovascularstrokecatatonicpsychosisacasereport
AT srabei postcerebrovascularstrokecatatonicpsychosisacasereport