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BMC Psychiatry

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Open Access 01-12-2020 | Electroconvulsive Therapy | Case report

Storms and silence: a case report of catatonia and paroxysmal sympathetic hyperactivity following cerebral hypoxia

Authors: Dallas Wolfgang Hamlin, Nuzhat Hussain, Aum Pathare

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

Delayed Post Hypoxic Leukoencephalopathy (DPHL) is a syndrome that occurs after hypoxia, and can present with a variety of neuropsychiatric symptoms, including catatonia and paroxysmal sympathetic hyperactivity (PSH). The gold standard for the treatment of catatonia is electroconvulsive therapy (ECT). However, ECT can exacerbate the paroxysms of sympathetic hyperactivity and complicate recovery from DPHL. The treatment of PSH is not well established.

Case presentation

We present a case of a patient with multiple opiate overdoses who presented with altered mental status. He was diagnosed with catatonia and subsequently treated with ECT. His clinical condition worsened, and a revised diagnosis of PSH was established. The patient’s condition improved with medical management.

Conclusion

This case highlights the need to distinguish between these two related symptom clusters, as the incidence of DPHL and opioid overdose related neuropsychiatric problems increase. This distinction can greatly influence the course of treatment, and the need to consider alternative treatments.

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Title: Storms and silence: a case report of catatonia and paroxysmal sympathetic hyperactivity following cerebral hypoxia
Authors: Dallas Wolfgang Hamlin
Nuzhat Hussain
Aum Pathare
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Electroconvulsive Therapy
Lorazepam
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02878-5

2024 ASCO Annual Meeting

Springer Medicine

Storms and silence: a case report of catatonia and paroxysmal sympathetic hyperactivity following cerebral hypoxia

Abstract

Background

Case presentation

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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