Abstract
Acute catatonia in an adolescent or young adult can present complex clinical challenges. Prominent issues include those involving diagnosis, timely and effective treatment, and diminished capacity to provide consent. The authors describe a 19-year-old woman presenting initially with manic excitement followed by a lengthy period of mutism, immobility, and food and fluid refusal. Elevated temperature, an elevated creatine phosphokinase level, and autonomic dysfunction led to consideration of a malignant catatonic syndrome. The patient manifested rigidity accompanied by posturing and waxy flexibility. Neurologic, medical, and laboratory evaluations failed to identify an organic cause for the likely catatonia. Treatment with amantadine, bromocriptine, and lorazepam was unsuccessful. ECT was deemed appropriate but required emergency guardianship because of the patient's inability to provide consent. At the initial ECT session, the elicited seizure was followed by an episode of torsade de pointes requiring immediate cardioversion. In reviewing the ECT complication, it appeared that muscle damage due to catatonic immobility led to acute hyperkalemia with the administration of succinylcholine. Discussions were held with the patient's g...Continue Reading
Citations
Nov 14, 2013·Medizinische Klinik, Intensivmedizin und Notfallmedizin·A WolfF-G B Pajonk
May 17, 2011·Journal of Anesthesia·Yukari KogaKazuo Ushijima
Jun 21, 2011·Psychiatry and Clinical Neurosciences·Tatsuya KuboNaohiro Kurotaki
Dec 17, 2010·Expert Review of Neurotherapeutics·Hazem Shoirah, Hesham M Hamoda
Jul 1, 2011·Revista de psiquiatrí́a y salud mental·Ernesto José Verdura VizcaínoJavier Sanz-Fuentenebro
Nov 19, 2011·Acta Anaesthesiologica Scandinavica·H MirzakhaniA Nozari
Jul 19, 2015·Der Nervenarzt·T MesserM J Müller
Nov 21, 2014·Journal of Neurology, Neurosurgery, and Psychiatry·Subhashie Wijemanne, Joseph Jankovic
Apr 14, 2017·Trends in psychiatry and psychotherapy·Kathy Aleixo MarcolinAngelo Batista Miralha da Cunha
Sep 2, 2017·Pacing and Clinical Electrophysiology : PACE·Yoko SuzukiEisuke Matsushima
Jun 10, 2011·Journal of the American Psychiatric Nurses Association·Tammy Cohen Fetterman, Patrick Ying
Nov 19, 2014·Journal of Psychiatric Practice·Michelle MagidDavid A Kahn
May 23, 2018·Neurology·David Dongkyung KimSarah A Morrow
Jan 12, 2019·The Journal of ECT·Vanessa StumpfSteven Lippmann
Feb 15, 2020·Journal of Medical Ethics·Giuseppe BersaniAngela Iannitelli
Jul 5, 2012·Journal of Clinical Psychopharmacology·David Freitas de LucenaClarissa Severino Gama
Sep 29, 2018·The South African Journal of Psychiatry : SAJP : the Journal of the Society of Psychiatrists of South Africa·Kavendren OdayarWillem Esterhuysen
Dec 19, 2020·The Journal of ECT·Estela SalagreSøren D Østergaard