Three case reports are presented to illustrate the diagnostic conundrum of delirious mania and several different presentations of malignant catatonia. [ncbi.nlm.nih.gov]

Addresses areas of controversy -- including disagreements over treatment and the nosologic status of catatonia -- head-on, in a balanced, evidence-based presentation. [books.google.com]

• Hyperthermia

  He presented with hyperthermia, tachycardia, hypertension, excessive sweating, and an elevated serum creatine phosphokinase (CPK) level. On the basis of these features, he was suspected to have NMS. [ncbi.nlm.nih.gov]

  Differential Diagnosis of catatonia Locked-in syndrome Seizures Malignant hyperthermia Parkinsonism Deception syndromes: What is Malignant hyperthermia occurs post-operatively reaction to inhalation anesthetics communicate via vertical eye movements and [quizlet.com]

  Our review also supports the proposed conceptualization of catatonia as a continuum, with milder forms at one end (termed simple or nonmalignant catatonia) and more severe forms involving hyperthermia and autonomic dysfunction (termed malignant catatonia [eurekaselect.com]

• Unconsciousness

  Case A 45-year-old man was brought to our hospital by Ambulance having been found lying unconscious on the pavement. On admission he was obtunded with a Glasgow Coma Score (GCS) of 6 (E1, V1, M4), but maintaining his airway. [academic.oup.com]

  She was conscious the night before admission, but was found unconscious and presenting breathing difficulty the next morning. Chest compressions were performed for three minutes, which returned SatO2 (oxygen saturation) from 35% to 90%. [scielo.br]

• Antipsychotic Agent

  Links PMC Free PDF PMC Free Full Text FREE Publisher Full Text Authors +Show Affiliations, aDepartment of Neuropsychiatry bClinical Training Center, Kanazawa Medical University, Ishikawa, Japan., ,, ,, Source MeSH Antipsychotic Agents Benzodiazepines [unboundmedicine.com]

  NMS is a strong possibility though, given that an antipsychotic agent has been commenced within the past month; this is supported by the markedly elevated creatine phosphokinase (CPK) levels and leukocytosis. [prognosisapp.com]

• Asymptomatic

  He was discharged from hospital one month later, fully asymptomatic except for a residuary amnesia, with a final diagnosis of idiopathic malignant catatonia. [pubmed.ncbi.nlm.nih.gov]

  For the asymptomatic patient, removal of the catheter and a short course of antibiotics are usually successful. [primarypsychiatry.com]

• Surgical Procedure

  Parturient with MHS Partner Temperature Monitoring during Surgical Procedures Post-MH Event Plan and Counseling Professional Development CME Zone Presentations Dr. [mhaus.org]

• Muscle Rigidity

  A 53-year-old man with schizophrenia was admitted to the psychiatric hospital because of excitement, monologue, muscle rigidity, and insomnia. [ncbi.nlm.nih.gov]

  CASE PRESENTATION A 53-year-old man with schizophrenia was admitted to the psychiatric hospital because of excitement, monologue, muscle rigidity, and insomnia. [unboundmedicine.com]

  When the dopamine receptors in the hypothalamus or another bundle of nerve fibers (nigrostriatal pathways) and/or the spinal cord are blocked, increased muscle rigidity is the result. [rarediseases.org]

  Although muscle rigidity may lead to an elevation in CPK, EPS are not typically accompanied by fever, autonomic instability, elevation of the white blood cell count, and other abnormal laboratory studies. [quizlet.com]

  In NMS, patients typically show symptoms such as an altered mental state, muscle rigidity, tremor, tachycardia, hyperpyrexia, leukocytosis, and elevated serum creatine phosphorous kinase. [industrialpsychiatry.org]

• Vascular Disease

  Coronary Artery Disease or Peripheral Vascular Disease. No change in standard management. E. Diabetes or other Endocrine issues. No change in standard management. F. Malignancy. No change in standard management. G. [clinicaladvisor.com]

• Suggestibility

  The authors review catatonia, especially malignant catatonia, suggest a revised nomenclature, and establish a basis for furthering our understanding and treatment of this syndrome. [ncbi.nlm.nih.gov]

  In addition, findings from our review suggest that simple catatonia, MC and NMS share a common pathophysiology involving reduced dopaminergic functioning in the basal ganglia-thalamocortical circuits, consistent with their identity as variants of the [eurekaselect.com]

  Our patient had a normal brain MRI and FDG-PET suggesting asymmetric thalamic hypometabolism which resolved with ECT, suggesting at least functional impairment in these anatomical areas. [jnnp.bmj.com]

• Negativism

  115 ページ - The presence of catatonia as manifested by motoric immobility, excessive motor activity (that is apparently purposeless and not influenced by external stimuli), extreme negativism or mutism, peculiarities of voluntary movement, or echolalia [books.google.com]

  […] patient experienced significant motor and communication delays with mild cognitive impairment, but was otherwise in good health until age 15 years, when he developed rigidity, posturing, stupor, unresponsiveness, repetitive self-injurious behaviors, and negativism [ncbi.nlm.nih.gov]

  Abstract Catatonia is a syndrome characterized by mutism, immobility, negativism, stereotypy, mannerisms, echophenomena, perseveration and passive obedience. [scopemed.org]

  Ind Psychiatry J 2014;23:163-5 Catatonia is a syndrome, comprised of symptoms such as motor immobility, excessive motor activity, extreme negativism, and stereotyped movements. [industrialpsychiatry.org]

  The essence of catatonia symptoms are: movement disorders, mutism, negativism, waxy flexibility, stereotypical movement, impulsive actions, duality, and paramimics. It is a psychosis that affects movement and speech. [llmd.lt]

• Stupor

  The authors only recognize stupor if there is total akinesis, where it is assumed that the diagnosis is schizophrenia. Depressive stupor is not recognized as an entity. [cambridge.org]

  This stage would be followed by exhaustion, characterized by stupor and by high temperatures. [clinicalgate.com]

  Applicable To Catatonic stupor Semicoma R40.1 ) stupor NOS ( ICD-10-CM Diagnosis Code R40.1 Stupor 2016 2017 2018 2019 Billable/Specific Code Applicable To Catatonic stupor Semicoma R40.1 ) Type 2 Excludes Type 2 Excludes Help A type 2 excludes note [icd10data.com]

  The patient experienced significant motor and communication delays with mild cognitive impairment, but was otherwise in good health until age 15 years, when he developed rigidity, posturing, stupor, unresponsiveness, repetitive self-injurious behaviors [ncbi.nlm.nih.gov]

  Stuporous catatonia is characterised by immobility during which people may hold rigid poses ( stupor ), an inability to speak ( mutism ), as well as waxy flexibility, in which they maintain positions after being placed in them by someone else. [en.wikipedia.org]

• Seizure

  At syndrome culmination the patient was hospitalized in the neurologic department because of hyperthermia and chorea-like hyperkinesis and myoclonus which are often mistaken for seizures. At that point there were obvious catatonic symptoms. [llmd.lt]

  Clinical case: A 24 year-old man presented with a generalized tonic-clonic seizure of focal onset. [pubmed.ncbi.nlm.nih.gov]

  M’s case, we considered several medical causes, including nutritional deficiency, infection, a toxin, renal or hepatic impairment, hypothyroidism, seizure, and stroke. [mdedge.com]

  Electroconvulsive therapy (ECT) was postponed due to arguments supporting hypothesis of acute encephalitis (seizures, EEG signs and brain hypometabolism). [ncbi.nlm.nih.gov]

• Convulsions

  Convulsive Therapy, 1991; 7:111-120. Mann SN, Caroff SN, Bleier HR, et al. Electroconvulsive therapy in the treatment of lethal catatonia: case report and review. Convulsive Therapy, 1990; 6: 239-247. [mhaus.org]

  Convulsive Therapy 8(4):267–279 Google Scholar Shalev A, Munitz H (1986) The neuroleptic malignant syndrome: agent and host interaction. [link.springer.com]

  On Day 5, as part of our workup for non-convulsive epilepsy, a trial of intravenous diazepam (5 mg) was given. [academic.oup.com]

  Diagnosis of catatonia Locked-in syndrome Seizures Malignant hyperthermia Parkinsonism Deception syndromes: What is Malignant hyperthermia occurs post-operatively reaction to inhalation anesthetics communicate via vertical eye movements and blinking, Non-convulsive [quizlet.com]

  A longer illness duration also seemed to predict a worse outcome in the first 11 patients treated by László Meduna, who invented convulsive therapy in 1934 ( 42, 43 ). [frontiersin.org]

• Cogwheel Rigidity

  Thus, the absence of fever, leukocytosis, autonomic instability, cogwheel rigidity, and altered sensorium indicated more toward the definitive diagnosis of catatonia rather than NMS. [industrialpsychiatry.org]

  No cogwheel rigidity. She does have some slight voluntary movement of her limbs, e.g. she moved her arm while I was doing passive leg movements. Reacts to pain and grimaces. [forums.studentdoctor.net]

• Motor Disturbances

  Remarkably the patient became completely alert (GCS 15/15), albeit briefly ( Catatonia is a neuropsychiatric syndrome characterized by motor disturbance. [academic.oup.com]

[…] a) EEG b) lumbar puncture c) MRI d) CT In approximately 25% of cases, catatonia is caused by a general medical condition 2 ; as such, a comprehensive medical workup is vital for assessment and management of catatonic patients. In Ms. [mdedge.com]

On Day 5, as part of our workup for non-convulsive epilepsy, a trial of intravenous diazepam (5 mg) was given. [academic.oup.com]

In children with this syndrome, electroconvulsive treatment should be considered. [ncbi.nlm.nih.gov]

Its short-term prognosis is of paramount importance. Without effective treatment, it is associated with high mortality. [em-consulte.com]

Classical catatonic signs, such as mutism, stupor, negativism, and excitement, do not by themselves indicate the etiology or determine the prognosis. The prognosis is better for catatonia occurring in a mood disorder than in schizophrenia. [primarypsychiatry.com]

Prognosis Prognosis of catatonia is good, especially with early and aggressive treatment. In mood disorders, prognosis is probably better than in psychotic disorders. [frontiersin.org]

It is crucial to diagnose and begin an appropriate treatment quickly to improve the patient's prognosis. Plasma exchange appears to be an efficient treatment option in SLE and catatonia, and it avoids the use of ECT [17,18]. [ncbi.nlm.nih.gov]

Prognosis and Patient Counseling. The majority of patients recover within 2 weeks, however, NMS can be life-threatening. Mortality rates when initially reported before 1970 were as high as 76%. [clinicaladvisor.com]

Conclusions: The authors have reviewed the management of this syndrome, which can be challenging for the physician because of the wide array of possible etiologies and its potentially lethal nature. [pubmed.ncbi.nlm.nih.gov]

Familiarity with the clinical features and varied etiologies is essential for effective management of this catastrophic reaction. [ncbi.nlm.nih.gov]

Kraepelin and Bleuler both believed that catatonic symptoms could emerge as part of a mood disorder (either mania or depression) or could result from neurologic, toxic-metabolic, and infectious etiologies. [clinicalgate.com]

This book covers in great detail the psychopathology and neurobiology of catatonia, focusing on the history, epidemiology, etiology, diagnosis and treatment of the disorder. [books.google.com]

Conventional treatment, benzodiazepine- and/or ECT-based, can solve the catatonic episode in a few days, irrespective of its etiology and its severity. [em-consulte.com]

This book covers in great detail the psychopathology and neurobiology of catatonia, focusing on the history, epidemiology, etiology, diagnosis and treatment of the disorder. [books.google.com]

Epidemiologic investigations show a high prevalence of functional psychoses and organic mental disorders. [books.google.ro]

Adityanjee, Aderibigbe, YA, Mathews, T: Epidemiology of Neuroleptic malignant syndrome. Clinical Neuropharmacology, 1999; 2:151-158. Gurrera RJ: Sympathoadrenal hyperactivity and the etiology of neuroleptic malignant syndrome. [mhaus.org]

Epidemiology. In: Caroff SN, Mann SC, Francis A, Fricchione G, editors. Catatonia: from psychopathology to neurobiology. Washington, DC: American Psychiatric Press; 2004. p. 15–31. [link.springer.com]

Its purported pathophysiology—frontal-striatal depletion of dopamine and GABA—overlaps considerably with that of NMS. [oxfordmedicine.com]

The pathophysiology is still unclear but most reports suggest a hypodopaminergic state. Its reported mortality has declined from 75-100% in the preneuroleptic era to 31% during the review period (1986-1992). [ncbi.nlm.nih.gov]

Although the findings in the present study cannot entirely explain the pathophysiology of malignant catatonia, they do indicate that hyperactivity of the sympathetic nervous system may be involved in the pathology of this condition. [dovepress.com]

In addition, findings from our review suggest that simple catatonia, MC and NMS share a common pathophysiology involving reduced dopaminergic functioning in the basal ganglia-thalamocortical circuits, consistent with their identity as variants of the [eurekaselect.com]

As a result, every psychiatrist, physician, and mental health care professional needs to understand and identify these disorders in time to prevent a fatal outcome. [books.google.com]

Frequently two to three ECT treatments will suffice, although four to six treatments are usually given to prevent relapse. [quizlet.com]

Springer, 13 ian. 2014 - 468 pagini In spite of progress in biomedical research, we know little about the causes, prevention, and treatment of the numerous mental and neurological disorders that afflict up to 15% of all individuals. [books.google.ro]

Preventing Catatonia Because the exact cause of catatonia is often unknown, prevention is not possible. However, patients should avoid taking excess neuroleptic medications, such as Thorazine. [healthline.com]

Published monthly on behalf of the Royal College of Psychiatrists, the journal is committed to improving the prevention, investigation, diagnosis, treatment, and care of mental illness, as well as the promotion of mental health globally. [bjp.rcpsych.org]