Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2023

Open Access 01-12-2023 | Electroconvulsive Therapy | Case report

Idiopathic catatonic syndrome in a young male with no prior psychiatric history: a case report

Authors: Jennifer L. Zick, Lora Wichser

Published in: Journal of Medical Case Reports | Issue 1/2023

Login to get access

Abstract

Background

Catatonia is a syndrome characterized by severe psychomotor disturbances such as hypomotility, bradykinesia, and unusual movements. The condition has been described in the context of a wide variety of primary disease processes, including psychotic and mood disorders and numerous general medical conditions. In the medical community, catatonia is misunderstood, under-recognized, and under-treated. There continues to be debate about whether catatonia is an independent syndrome or a secondary expression of other conditions. This is a unique case presentation, as there are few reports describing cases of isolated catatonic syndrome in the absence of any other psychiatric or medical condition.

Case Presentation

We present the case of a 20-year-old previously healthy Caucasian male whose initial presentation to psychiatric care was in the form of an acute catatonic syndrome dominated by mutism, blank staring, and poverty of movement. As the nature of the patient’s symptoms precluded the collection of a complete psychiatric  and medical history, we employed a broad differential diagnosis including catatonia due to another medical condition, catatonia as a specifier for a number of mental disorders, and catatonia not otherwise specified.

Conclusions

The presentation of an acute onset of psychomotor symptoms in the absence of a history of mental illness warrants extensive workup to rule out medical causes to ensure effective treatment of any underlying illness. Benzodiazepines are the first-line treatment for catatonic symptoms, and electroconvulsive therapy can be used to resolve symptoms in patients who do not respond to medical intervention.
Literature
1.
go back to reference Kahlbaum KL. Klinische Abhandlungen über psychische Krankheiten: eine klinische Form psychischer Krankheit. Die Katatonie oder das Spannungsirresein. Verlag von August Hirschwald; 1874. Kahlbaum KL. Klinische Abhandlungen über psychische Krankheiten: eine klinische Form psychischer Krankheit. Die Katatonie oder das Spannungsirresein. Verlag von August Hirschwald; 1874.
2.
go back to reference Fink M, Shorter E, Taylor MA. Catatonia is not schizophrenia: Kraepelin’s error and the need to recognize catatonia as an independent syndrome in medical nomenclature. Schizophr Bull. 2010;36(2):314–20.CrossRefPubMed Fink M, Shorter E, Taylor MA. Catatonia is not schizophrenia: Kraepelin’s error and the need to recognize catatonia as an independent syndrome in medical nomenclature. Schizophr Bull. 2010;36(2):314–20.CrossRefPubMed
4.
go back to reference Abrams R, Taylor MA. Catatonia. A prospective clinical study. Arch Gen Psychiatry. 1976;33(5):579–81.CrossRefPubMed Abrams R, Taylor MA. Catatonia. A prospective clinical study. Arch Gen Psychiatry. 1976;33(5):579–81.CrossRefPubMed
5.
go back to reference Taylor MA, Abrams R. Catatonia. Prevalence and importance in the manic phase of manic-depressive illness. Arch Gen Psychiatry. 1977;34(10):1223–5.CrossRefPubMed Taylor MA, Abrams R. Catatonia. Prevalence and importance in the manic phase of manic-depressive illness. Arch Gen Psychiatry. 1977;34(10):1223–5.CrossRefPubMed
6.
go back to reference Tandon R, Heckers S, Bustillo J, Barch DM, Gaebel W, Gur RE, et al. Catatonia in DSM-5. Schizophr Res. 2013;150(1):26–30.CrossRefPubMed Tandon R, Heckers S, Bustillo J, Barch DM, Gaebel W, Gur RE, et al. Catatonia in DSM-5. Schizophr Res. 2013;150(1):26–30.CrossRefPubMed
7.
go back to reference American Psychiatric Association A. Diagnostic and statistical manual of mental disorders, 5th Edition: DSM-5 American Psychiatric Association. 2013. American Psychiatric Association A. Diagnostic and statistical manual of mental disorders, 5th Edition: DSM-5 American Psychiatric Association. 2013.
8.
9.
go back to reference Huang TL, Ree SC, Huang YC, Liu HY, Yang YY. Catatonic features: differential diagnosis and treatments at an emergency unit. Psychiatry Clin Neurosci. 1999;53(1):63–6.CrossRefPubMed Huang TL, Ree SC, Huang YC, Liu HY, Yang YY. Catatonic features: differential diagnosis and treatments at an emergency unit. Psychiatry Clin Neurosci. 1999;53(1):63–6.CrossRefPubMed
10.
go back to reference Manjunatha N, Saddichha S, Khess CRJ. Idiopathic recurrent catatonia needs maintenance lorazepam: case report and review. Aust N Z J Psychiatry. 2007;41(7):625–7.CrossRefPubMed Manjunatha N, Saddichha S, Khess CRJ. Idiopathic recurrent catatonia needs maintenance lorazepam: case report and review. Aust N Z J Psychiatry. 2007;41(7):625–7.CrossRefPubMed
11.
go back to reference Taylor MA, Fink M. Catatonia in psychiatric classification: a home of its own. Am J Psychiatry. 2003;160(7):1233–41.CrossRefPubMed Taylor MA, Fink M. Catatonia in psychiatric classification: a home of its own. Am J Psychiatry. 2003;160(7):1233–41.CrossRefPubMed
13.
go back to reference Fink M. Rediscovering catatonia: the biography of a treatable syndrome. Acta Psychiatr Scand Suppl. 2013;441:1–47.CrossRef Fink M. Rediscovering catatonia: the biography of a treatable syndrome. Acta Psychiatr Scand Suppl. 2013;441:1–47.CrossRef
14.
go back to reference Llesuy JR, Medina M, Jacobson KC, Cooper JJ. Catatonia under-diagnosis in the general hospital. J Neuropsychiatry Clin Neurosci. 2018;30(2):145–51.CrossRefPubMed Llesuy JR, Medina M, Jacobson KC, Cooper JJ. Catatonia under-diagnosis in the general hospital. J Neuropsychiatry Clin Neurosci. 2018;30(2):145–51.CrossRefPubMed
15.
go back to reference Grover S, Chakrabarti S, Ghormode D, Agarwal M, Sharma A, Avasthi A. Catatonia in inpatients with psychiatric disorders: a comparison of schizophrenia and mood disorders. Psychiatry Res. 2015;229(3):919–25.CrossRefPubMed Grover S, Chakrabarti S, Ghormode D, Agarwal M, Sharma A, Avasthi A. Catatonia in inpatients with psychiatric disorders: a comparison of schizophrenia and mood disorders. Psychiatry Res. 2015;229(3):919–25.CrossRefPubMed
16.
go back to reference Stuivenga M, Morrens M. Prevalence of the catatonic syndrome in an acute inpatient sample. Front Psychiatry. 2014;3(5):174. Stuivenga M, Morrens M. Prevalence of the catatonic syndrome in an acute inpatient sample. Front Psychiatry. 2014;3(5):174.
17.
go back to reference Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996;93(2):129–36.CrossRefPubMed Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996;93(2):129–36.CrossRefPubMed
18.
go back to reference Khan M, Pace L, Truong A, Gordon M, Moukaddam N. Catatonia secondary to synthetic cannabinoid use in two patients with no previous psychosis. Am J Addict. 2016;25(1):25–7.CrossRefPubMed Khan M, Pace L, Truong A, Gordon M, Moukaddam N. Catatonia secondary to synthetic cannabinoid use in two patients with no previous psychosis. Am J Addict. 2016;25(1):25–7.CrossRefPubMed
19.
go back to reference Caudron M, Rolland B, Deheul S, Geoffroy PA, Thomas P, Amad A. Catatonia and cannabis withdrawal: a case report. Subst Abus. 2016;37(1):188–9.CrossRefPubMed Caudron M, Rolland B, Deheul S, Geoffroy PA, Thomas P, Amad A. Catatonia and cannabis withdrawal: a case report. Subst Abus. 2016;37(1):188–9.CrossRefPubMed
20.
go back to reference Dhossche D, Bouman N. Catatonia in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1997;36(7):870–1.CrossRefPubMed Dhossche D, Bouman N. Catatonia in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1997;36(7):870–1.CrossRefPubMed
22.
go back to reference Nocton JJ, Bloom BJ, Rutledge BJ, Persing DH, Logigian EL, Schmid CH, et al. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in cerebrospinal fluid in Lyme neuroborreliosis. J Infect Dis. 1996;174(3):623–7.CrossRefPubMed Nocton JJ, Bloom BJ, Rutledge BJ, Persing DH, Logigian EL, Schmid CH, et al. Detection of Borrelia burgdorferi DNA by polymerase chain reaction in cerebrospinal fluid in Lyme neuroborreliosis. J Infect Dis. 1996;174(3):623–7.CrossRefPubMed
23.
go back to reference Pfister HW, Preac-Mursic V, Wilske B, Rieder G, Förderreuther S, Schmidt S, et al. Catatonic syndrome in acute severe encephalitis due to Borrelia burgdorferi infection. Neurology. 1993;43(2):433–5.CrossRefPubMed Pfister HW, Preac-Mursic V, Wilske B, Rieder G, Förderreuther S, Schmidt S, et al. Catatonic syndrome in acute severe encephalitis due to Borrelia burgdorferi infection. Neurology. 1993;43(2):433–5.CrossRefPubMed
25.
go back to reference Rebman AW, Crowder LA, Kirkpatrick A, Aucott JN. Characteristics of seroconversion and implications for diagnosis of post-treatment Lyme disease syndrome: acute and convalescent serology among a prospective cohort of early Lyme disease patients. Clin Rheumatol. 2015;34(3):585–9.CrossRefPubMed Rebman AW, Crowder LA, Kirkpatrick A, Aucott JN. Characteristics of seroconversion and implications for diagnosis of post-treatment Lyme disease syndrome: acute and convalescent serology among a prospective cohort of early Lyme disease patients. Clin Rheumatol. 2015;34(3):585–9.CrossRefPubMed
26.
go back to reference Fink M. Taylor MA. Catatonia: A clinician’s guide to diagnosis and treatment. Cambridge University Press; 2006. p. 276. Fink M. Taylor MA. Catatonia: A clinician’s guide to diagnosis and treatment. Cambridge University Press; 2006. p. 276.
27.
go back to reference Dutt A, Grover S, Chakrabarti S, Avasthi A, Kumar S. Phenomenology and treatment of Catatonia: a descriptive study from north India. Indian J Psychiatry. 2011;53(1):36–40.CrossRefPubMedPubMedCentral Dutt A, Grover S, Chakrabarti S, Avasthi A, Kumar S. Phenomenology and treatment of Catatonia: a descriptive study from north India. Indian J Psychiatry. 2011;53(1):36–40.CrossRefPubMedPubMedCentral
28.
go back to reference Rohland BM, Carroll BT, Jacoby RG. ECT in the treatment of the catatonic syndrome. J Affect Disord. 1993;29(4):255–61.CrossRefPubMed Rohland BM, Carroll BT, Jacoby RG. ECT in the treatment of the catatonic syndrome. J Affect Disord. 1993;29(4):255–61.CrossRefPubMed
29.
go back to reference England ML, Ongür D, Konopaske GT, Karmacharya R. Catatonia in psychotic patients: clinical features and treatment response. J Neuropsychiatry Clin Neurosci. 2011;23(2):223–6.CrossRefPubMedPubMedCentral England ML, Ongür D, Konopaske GT, Karmacharya R. Catatonia in psychotic patients: clinical features and treatment response. J Neuropsychiatry Clin Neurosci. 2011;23(2):223–6.CrossRefPubMedPubMedCentral
30.
go back to reference Hatta K, Miyakawa K, Ota T, Usui C, Nakamura H, Arai H. Maximal response to electroconvulsive therapy for the treatment of catatonic symptoms. J ECT. 2007;23(4):233–5.CrossRefPubMed Hatta K, Miyakawa K, Ota T, Usui C, Nakamura H, Arai H. Maximal response to electroconvulsive therapy for the treatment of catatonic symptoms. J ECT. 2007;23(4):233–5.CrossRefPubMed
31.
go back to reference Medda P, Toni C, Luchini F, Giorgi Mariani M, Mauri M, Perugi G. Catatonia in 26 patients with bipolar disorder: clinical features and response to electroconvulsive therapy. Bipolar Disord. 2015;17(8):892–901.CrossRefPubMed Medda P, Toni C, Luchini F, Giorgi Mariani M, Mauri M, Perugi G. Catatonia in 26 patients with bipolar disorder: clinical features and response to electroconvulsive therapy. Bipolar Disord. 2015;17(8):892–901.CrossRefPubMed
32.
go back to reference Ungvari GS, Kau LS, Wai-Kwong T, Shing NF. The pharmacological treatment of catatonia: an overview. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 1):I31–4.CrossRefPubMed Ungvari GS, Kau LS, Wai-Kwong T, Shing NF. The pharmacological treatment of catatonia: an overview. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 1):I31–4.CrossRefPubMed
33.
go back to reference Rosebush PI, Hildebrand AM, Furlong BG, Mazurek MF. Catatonic syndrome in a general psychiatric inpatient population: frequency, clinical presentation, and response to lorazepam. J Clin Psychiatry. 1990;51(9):357–62.PubMed Rosebush PI, Hildebrand AM, Furlong BG, Mazurek MF. Catatonic syndrome in a general psychiatric inpatient population: frequency, clinical presentation, and response to lorazepam. J Clin Psychiatry. 1990;51(9):357–62.PubMed
34.
go back to reference Fink M. Catatonia: syndrome or schizophrenia subtype? Recognition and treatment. J Neural Transm. 2001;108(6):637–44.CrossRefPubMed Fink M. Catatonia: syndrome or schizophrenia subtype? Recognition and treatment. J Neural Transm. 2001;108(6):637–44.CrossRefPubMed
35.
go back to reference Fink M. Induced seizures as psychiatric therapy: Ladislas Meduna’s contributions in modern neuroscience. J ECT. 2004;20(3):133–6.CrossRefPubMed Fink M. Induced seizures as psychiatric therapy: Ladislas Meduna’s contributions in modern neuroscience. J ECT. 2004;20(3):133–6.CrossRefPubMed
Metadata
Title
Idiopathic catatonic syndrome in a young male with no prior psychiatric history: a case report
Authors
Jennifer L. Zick
Lora Wichser
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2023
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-023-03903-3

Other articles of this Issue 1/2023

Journal of Medical Case Reports 1/2023 Go to the issue