European Journal of Biomedical and Pharmaceutical Sciences

CATATONIA- A CLINICAL IMPOSTER

Amit Chail, Hapreet Singh, Sargundeep Singh* and Bharat Khadka

ABSTRACT

Catatonia is a neuro-behavioural syndrome with autonomic, behavioral and motoric manifestation accompanying many medical and neurologic disorders.[1] It was first described in Karl ludwig Kahalbum in 1874 in his book Die Katatonie oder das Spannungsirresein.[2] During the early part of 20th century, it was considered a type of schizophrenia. However in the 1970s, it begin to be identified with many other disorders like mania and depression, as a toxic response and in general medical and neurologic illnesses.[3] Presently in ICD-10 it continues to be a part of Schizophrenai but in DSM-V it has been made a separate entity.[4] The draft version of ICD 11 also places it as a separate entity.[5] Two subtypes of the syndrome have been identified i.e retarded type and excited type.[6] Medical complications of the syndrome include aspiration, dehydration, pulmonary emboli, acute renal failure, cardiac arrest and death.[7] There are various conditions which mimics catatonia like Non-catatonic stupor, Encephalopathy, Stroke, Stiff-Person syndrome, Locked-in syndrome, Malignant hyperthermia, Status epilepticus etc.[8] Becuase of being not so common presentation, it is often confused with other diseases, so here we present a 21 years old student, who presented with two episodes of unresponsiveness and abnormal behaviour, initially was being managed as a case of Seizure disorder and Ictal Psychosis, however subsequent ward observation revealed otherwise.

Keywords: Catatonia, Psychogenic non epileptic seizures, Catatonia mimics, Bipolar Affective Disorder, Echopraxia, Stupor.