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Inicio Revista Colombiana de Psiquiatría (English Edition) Case Report of Retarded Catatonia: Always Consider Catatonia as a Differential D...
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Vol. 53. Issue 2.
Pages 206-209 (April - June 2024)
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Vol. 53. Issue 2.
Pages 206-209 (April - June 2024)
Reporte de caso
Case Report of Retarded Catatonia: Always Consider Catatonia as a Differential Diagnosis of Altered Mental Status
Informe de un caso de catatonia retardada: Considerar siempre la catatonia como diagnóstico diferencial de la alteración del estado mental
Irma Munoz Verdugoa,
Corresponding author
irmamunozmd@gmail.com

Corresponding author.
, Jose Lopezb, Sandra Cordovac
a Department of Internal Medicine, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador
b Department of Internal Medicine, Doctors Hospital at Renaissance DHR Hospital, McAllen, United States of America
c Department of Internal Medicine, Universidad Central del Ecuador, Quito, Ecuador
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Table 1. Signs and symptoms of Acute Catatonia by Karl Kahlbaum et al2.
Abstract
Background

Catatonia is a rare neuropsychiatric condition; it is estimated that around 10% of patients with mood disorders present signs and symptoms of catatonia. A catatonic syndrome is characterised by mutism, negativism, rigidity, and stupor.

Case report

We report the case of a 59-year-old patient with a medical history of bipolar disorder who was admitted to the internal medicine service due to a seizure episode. During hospitalisation, the patient presented significant worsening of her clinical condition, showing marked symptoms of stupor and catatonia. Once the neurological and metabolic etiologies of altered mental status had been ruled out, pharmacological treatment with high doses of lorazepam was started. The patient had a complete clinical remission, and her evolution was favourable without any complications. Electroconvulsive therapy was recommended as a definitive treatment.

Conclusions

The diagnosis of catatonia is a challenge for both hospitalists and psychiatrists due to the clinical presentation of catatonia. In reporting this clinical case, we want to emphasise the importance of taking into account the catatonic syndrome in our differential diagnoses in patients with altered mental status.

Keywords:
Catatonia
Benzodiazepines
Electroconvulsive therapy
Resumen
Introducción

La catatonía es una condición neuropsiquiátrica poco frecuente, se estima que cerca del 10% de los pacientes con trastornos afectivos presentan signos y síntomas de catatonía. El síndrome se caracteriza clínicamente por mutismo, negativismo, rigidez y estupor.

Caso clínico

Se describe el caso clínico de una paciente de 59 años con antecedentes de trastorno bipolar, ingresada por el servicio de medicina interna por un episodio de crisis convulsiva. Durante la hospitalización, la paciente presentó un importante deterioro clínico, marcado estupor y síntomas de catatonía. Una vez descartadas etiologías neurológicas y metabólicas de la alteración del estado de conciencia, se inició el tratamiento farmacológico con altas dosis de lorazepam. El cuadro clínico de la paciente evolucionó favorablemente con una remisión clínica completa.

Conclusiones

El diagnóstico de catatonía constituye un reto tanto para médicos internistas como psiquiatras por su presentación clínica. Con el reporte de este caso clínico se desea enfatizar la importancia de considerar al síndrome catatónico en nuestros diagnósticos diferenciales en pacientes con alteración del estado de conciencia.

Palabras clave:
Catatonía
Benzodiacepinas
Terapia electroconvulsiva

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