A Complicated Case of Catatonia
Introduction Many different causes of catatonia are well-documented in medicine. Modern understanding of catatonia has evolved in the last 100 years with the suggestion that there is a root cause in neuroinflammation. This is a case report of a young woman who presented to the emergency department...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822012172/type/journal_article |
| _version_ | 1797616171527176192 |
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| author | A. Makela |
| author_facet | A. Makela |
| author_sort | A. Makela |
| collection | DOAJ |
| description |
Introduction
Many different causes of catatonia are well-documented in medicine. Modern understanding of catatonia has evolved in the last 100 years with the suggestion that there is a root cause in neuroinflammation. This is a case report of a young woman who presented to the emergency department with altered mental status, found to have catatonia responsive to lorazepam, with the underlying etiology being a diagnosis of multiple sclerosis.
Objectives
A case-based approach is used to support the following learning objectives: - Review the diagnostic criteria for catatonia - Distinguish between simple and malignant catatonia - Review the Bush-Francis Scale - Review available treatment
Methods
Mother brings 24-year-old woman into the hospital for altered mental status and changes in behavior including staring spells, periods of withdrawal, refusal to eat, lack of purposeful movement, apraxia, and mutism that worsened 24 hours prior to presentation.
Results
The patient was afebile with negative covid-19 test. Recent diagnosis of Bell’s palsy treated with antivirals and oral steroird, which terminated just prior to presentation. Additionally, patient had outpatient treatment for vertigo. Lumbar puncture was negative for an infectious process. MRI revealed multiple stable white matter lesions in the periventricular, pontine, and subcortical regions, some oriented perpendicular to the corpus callosum.
Conclusions
This case of a 24-year-old woman with catatonia brought an opportunity to retrospectively review a case in detail in order to feature learning objectives that review very important considerations in the evaluation, differential diagnosis, symptom tracking, and treatment of catatonia. The future of research in catatonia is bright and diverse.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:37:33Z |
| format | Article |
| id | doaj.art-ebb08f5a8bb34b9685361378f8486a43 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:37:33Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-ebb08f5a8bb34b9685361378f8486a432023-11-17T05:09:24ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S479S47910.1192/j.eurpsy.2022.1217A Complicated Case of CatatoniaA. Makela0Harvard Medical School at Cambridge Health Alliance, Department Of Psychiatry, Cambridge, United States of America Introduction Many different causes of catatonia are well-documented in medicine. Modern understanding of catatonia has evolved in the last 100 years with the suggestion that there is a root cause in neuroinflammation. This is a case report of a young woman who presented to the emergency department with altered mental status, found to have catatonia responsive to lorazepam, with the underlying etiology being a diagnosis of multiple sclerosis. Objectives A case-based approach is used to support the following learning objectives: - Review the diagnostic criteria for catatonia - Distinguish between simple and malignant catatonia - Review the Bush-Francis Scale - Review available treatment Methods Mother brings 24-year-old woman into the hospital for altered mental status and changes in behavior including staring spells, periods of withdrawal, refusal to eat, lack of purposeful movement, apraxia, and mutism that worsened 24 hours prior to presentation. Results The patient was afebile with negative covid-19 test. Recent diagnosis of Bell’s palsy treated with antivirals and oral steroird, which terminated just prior to presentation. Additionally, patient had outpatient treatment for vertigo. Lumbar puncture was negative for an infectious process. MRI revealed multiple stable white matter lesions in the periventricular, pontine, and subcortical regions, some oriented perpendicular to the corpus callosum. Conclusions This case of a 24-year-old woman with catatonia brought an opportunity to retrospectively review a case in detail in order to feature learning objectives that review very important considerations in the evaluation, differential diagnosis, symptom tracking, and treatment of catatonia. The future of research in catatonia is bright and diverse. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822012172/type/journal_articleBush Francismultiple sclerosisinflammationCatatonia |
| spellingShingle | A. Makela A Complicated Case of Catatonia European Psychiatry Bush Francis multiple sclerosis inflammation Catatonia |
| title | A Complicated Case of Catatonia |
| title_full | A Complicated Case of Catatonia |
| title_fullStr | A Complicated Case of Catatonia |
| title_full_unstemmed | A Complicated Case of Catatonia |
| title_short | A Complicated Case of Catatonia |
| title_sort | complicated case of catatonia |
| topic | Bush Francis multiple sclerosis inflammation Catatonia |
| url | https://www.cambridge.org/core/product/identifier/S0924933822012172/type/journal_article |
| work_keys_str_mv | AT amakela acomplicatedcaseofcatatonia AT amakela complicatedcaseofcatatonia |