1/23. Malignant catatonia-induced respiratory failure with response to ECT.A 47-year-old acutely psychotic schizophrenic man was diagnosed with malignant catatonia. Because of a history of neuroleptic malignant syndrome (NMS), traditional neuroleptics were avoided, and the patient had been treated with reserpine for a period of 10 years. Symptomatically, severe agitation alternated with severe retardation. The syndrome progressed, despite early termination of any neuroleptic medications, to marked catatonic rigidity and dehydration. Worsening was associated with transfer to a medical intensive care unit, intubation, and subsequently a tracheostomy. dantrolene and bromocriptine were unhelpful. lorazepam produced muscular relaxation and resulting decreases in creatine phosphokinase levels but elicited no other improvement. Eleven bilateral electroconvulsive treatments, however, resolved the respiratory impairment and catatonia and improved the psychosis. This report highlights the efficacy of ECT in lethal catatonia despite respiratory impairment and tracheostomy.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
2/23. Severe catatonia and neuroleptic malignant syndrome: report of 3 cases.catatonia is a syndrome characterized by motor rigidity or stupor, negativism, mutism and inappropriate or bizarre posture. Without proper management, patients may have significant morbidity and mortality from stupor, coma and death (lethal or malignant catatonia). neuroleptic malignant syndrome (NMS) is characterized by a sudden appearance of motor rigidity, fever, autonomic effect, increased white blood cell count, serum creatinine phosphokinase, liver enzymes, and myoglobin. The mortality rate is 15 per cent to 25 per cent or even higher when depot form of neuroleptic is used. We report a patient with severe catatonia and two cases of NMS. death was encountered with one of the latter.- - - - - - - - - - ranking = 2keywords = rigidity (Clic here for more details about this article) |
3/23. catatonia, autism, and ECT.We describe the clinical presentation, course, and treatment response of a 14-year-old boy with catatonic stupor. This patient, with a preexisting diagnosis of autism, displayed mutism, akinesia, and an extreme level of rigidity, waxy flexibility, posturing, including the psychological pillow, facial grimacing, and other involuntary movements of his upper extremities. In addition he had symptoms suggestive of a depressive disorder as well as some non-specific psychotic symptoms. Intravenous injection of sodium amytal failed to resolve any motor symptoms, although he showed a good response to the zolpidem test. A course of electroconvulsive therapy (ECT) caused dramatic and sustained relief of catatonic stupor without a change in the symptoms of autism. The presentation of catatonia in autism and the use of ECT in children are discussed, and the available literature reviewed. This is the first description of the use of ECT in the treatment of catatonia coinciding with autism and we confirm its efficacy.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
4/23. ECT treatment of malignant catatonia/NMS in an adolescent: a useful lesson in delayed diagnosis and treatment.A 17-year-old adolescent female presented to a psychiatric emergency room with excitement, confusion, and psychotic symptoms. After brief exposure to haloperidol and olanzapine, she developed fever, rigidity, waxy flexibility, autonomic instability, and elevated creatinine phosphokinase enzyme. Approximately 6 weeks after the onset of the illness, multiple laboratory tests, and evaluation at three different hospitals, the condition was effectively treated with electroconvulsive therapy (ECT). This case is a lesson in delayed recognition and the delayed use of ECT for the malignant catatonia/neuroleptic malignant syndrome.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
5/23. catatonia and the neuroleptic malignant syndrome--a single entity?Separate episodes of both catatonia and the so-called 'neuroleptic malignant syndrome' (NMS) occurred within the same patient. The only evidence for NMS in this case was prior administration of a neuroleptic and the presence of generalised muscular rigidity. It is suggested that it is misleading to view these conditions as separate diagnostic entities and that NMS is probably more correctly incorporated into the catatonic disorders.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
6/23. Potentiation of haloperidol neurotoxicity in acute hyperthyroidism: report of a case.haloperidol has been used extensively for the treatment of many psychiatric illnesses as well as for control of agitated patients. Side effects including anticholinergic, extrapyramidal, sedative side effects as well as neuroleptic malignant syndrome are not unusual. Many factors may contribute to these complications including withdrawal or toxicity, concomitant use of other medications or the underlying illness itself. We report a case without previous history of thyroid disorder sufferring acute manic episode. haloperidol was prescribed to control psychotic symptoms. Symptoms and signs of extrapyramidal syndrome, catatonia and hyperthyroidism ensued. Prescription of anti-thyroid agents and discontinuation of haloperidol were essential in the successful treatment of this patient. It is hypothesized that underlying hyperthyroidism might have precipitated haloperidol neurotoxicity. haloperidol might play a role in the exacerbation of hyperthyroidism.- - - - - - - - - - ranking = 0.053699825753862keywords = extrapyramidal (Clic here for more details about this article) |
7/23. catatonia causing permanent cognitive impairment: a case study.OBJECTIVE: We describe a case of psychogenic malignant catatonia resulting in permanent cognitive impairment. BACKGROUND: catatonia is a neuropsychiatric syndrome characterized by catalepsy, negativism, mutism, muscular rigidity, and mannerisms, often accompanied by autonomic instability and fever. Little is known about the long-term cognitive consequences of the syndrome. METHOD: Medical history includes neurologic examination, neuropsychological evaluation, electroencephalographic data, magnetic resonance imaging, sodium amytal interview, and treatment with electroconvulsive therapy. RESULTS: Selective deficits in executive function and an anterograde amnesia were evident a week post-ECT treatment and continued to be present at follow-up after 2 years and 8 months. CONCLUSION: The permanent cognitive impairments are considered in the context of catatonia as a frontal lobe syndrome.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
8/23. Zotepine-induced catatonia as a precursor in the progression to neuroleptic malignant syndrome.A 39-year-old man with schizophrenia developed severe catatonia, hyperthermia, muscle rigidity, tachycardia, leukocytosis, and elevated muscle enzyme levels while receiving zotepine therapy. neuroleptic malignant syndrome (NMS) was diagnosed. After withdrawal of zotepine therapy, transfer to a neurologic intensive care unit, provision of supportive care, and administration of adjunctive bromocriptine therapy, the patient's fever and catatonia subsided. Biochemical irregularities spontaneously returned to normal with no complications. Antipsychotic therapy was restarted with risperidone 12 days after the patient's NMS resolved. After more than 1 year of follow-up, he experienced no adverse events. A recent decrease in mortality from NMS is related to increased awareness of this disorder, but not to treatment with specific agents. Clinicians need to recognize NMS early; although rare, it is a potentially fatal complication of antipsychotic treatment.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
9/23. Malignant catatonia with severe bronchorrhea and its response to electroconvulsive therapy.A 21-year-old female presented excitement, auditory hallucination, monologue, and insomnia. After 1 week of risperidone administration, she showed hyperthermia, salivation, and muscle rigidity. risperidone was discontinued, but stupor, convulsions, and respiratory distress developed. In the intensive care unit where she was transferred, catatonic symptoms such as stupor or excitement, catalepsy, and negativism were prominent. In addition, severe bronchorrhea causing respiratory failure was observed. Her catatonic symptoms, hyperthermia, and bronchorrhea resolved by ECT. After recovery, affective flattening, alogia, and avolition remained. The final diagnosis was MC associated with schizophrenia. This report suggests that MC may be complicated by severe bronchorrhea, but this condition responds to ECT.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
10/23. Treatment of catatonic stupor with combination of modified electroconvulsive treatment and olanzapine: a case report.This case report is about the combined use of modified electroconvulsive treatment and an atypical antipsychotic drug, olanzapine, in the treatment of a 20-year-old man with chronic and refractory catatonic stupor. This patient, with a preexisting diagnosis of autism, posturing, nonverbal communication, and contracture of lower extremities, displaying mutism, akinesia, and an extreme level of rigidity, waxy flexibility, and posturing, was diagnosed as with catatonic stupor. After hospitalization, the disease had progressed despite the treatment with an atypical antipsychotic drug, olanzapine. Modified electroconvulsive treatment together with olanzapine caused a dramatic clinical improvement. Follow-up outpatient treatment with olanzapine improved his social functions.- - - - - - - - - - ranking = 1keywords = rigidity (Clic here for more details about this article) |
| | Next -> |