Delayed onset hypokinetic-rigid syndrome due to hypoxic-ischemic damage of the striatum

Excerpt

A 43 years old woman was consulted in the psychiatric ward for acute signs of catatonia. She was scheduled for electroconvulsive therapy. Her medical history showed a borderline personality disorder, depression and back surgery. Six  weeks preceding our consultation, she had a cardiac arrest following an auto-intoxication with benzodiazepines. She was resuscitated 30 min, followed by cooling for 24 h. Four days later she was discharged from the hospital without any neurological sequela. After 6 weeks she was re-admitted for severe rigidity and hypokinesia with a subacute onset. At examination she was comprehensive but mutistic. She was able to communicate by pointing at a letter chart with her eyes. Her limbs were symmetrical hypokinetic and rigid with cogwheel phenomenon. Due to the hypokinetic-rigid syndrome she was bedbound. …