Catatonia

Revision as of 18:44, 10 September 2021 by Blsimpso (talk | contribs) (→‎Background)

Background

  • Catatonia is a syndrome characterized by psychomotor abnormalities, often presenting as a state of apparent unresponsiveness to external stimuli or inability to move normally in a person who is awake[1]
  • Classically associated with schizophrenia, but may also present in bipolar, PTSD, autism, encephalitis, and other neurologic disorders
  • If left untreated, can progress into malignant catatonia (20% mortality)

Clinical Features

Differential Diagnosis

Evaluation

Workup

Diagnosis

Management

  • "Benzodiazepine challenge" (first-line treatment)
    • Lorazepam IV 2mg; repeat prn
    • 60-70% of patients will achieve remission with benzodiazepine monotherapy[2]
  • Second line treatment is electro-convulsive therapy (ECT)
    • 80-100% effective


Avoid antipsychotic medications, as they may worsen symptoms

Disposition

See Also

External Links

References

  1. ↑ Fink M. The catatonia syndrome: forgotten but not gone. Arch Gen Psychiatry. 2009. 66:1173
  2. ↑ Luchini F, Medda P, Mariani MG, Mauri M, Toni C, Perugi G. Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response. World J Psychiatry. 2015;5(2):182-192. doi:10.5498/wjp.v5.i2.182
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