eMedicine Specialties > Neurology > Movement and Neurodegenerative Diseases
Catatonia
Updated: Dec 16, 2009
Introduction
Background
Catatonia is not a diagnosis. Rather, catatonia is a descriptive term for a presentation observed in a wide variety of disorders. While there exists a vast differential diagnosis for catatonia, the identification of treatable causes, such as non-convulsive status epilepticus, is crucial to the administration of the needed interventions. Psychomotor manifestations of catatonia1 analyzed by latent class techniques have been divided into 4 classes as follows: automatic, repetitive/echo, withdrawal, and agitated/resistive.2 When faced with a patient with catatonia, the clinician must first rule out treatable causes.
Catatonia (1) is a state of apparent unresponsiveness to external stimuli in a person who is apparently awake and (2) is difficult to differentiate from diffuse encephalopathy and nonconvulsive status epilepticus (see Epileptic and Epileptiform Encephalopathies and Focal Status Epilepticus).
This syndrome occurs in children, adolescents, and adults; is associated with a heterogeneous group of comorbid conditions; and is characterized by a variety of symptoms and signs of impairment of the expression of voluntary thoughts and movements. Typically, the syndrome of catatonia is episodic, with periods of remission. The accurate prompt diagnosis of catatonia is crucial to prevent morbidity and death in a variety of emergency medicine, psychiatric, neurologic, medical, obstetric, and surgical settings and to institute effective interventions, including benzodiazepines (eg, clonazepam, lorazepam, midazolam), zolpidem, atypical neuroleptics, tricyclic antidepressants, muscle relaxants, amobarbital, reserpine, thyroid hormone, lithium carbonate, bromocriptine, and electroconvulsive treatments (ECT).
A similar pathophysiology for catatonia and the neuroleptic malignant syndrome after exposure to antipsychotic medications, including typical and atypical neuroleptics, is suggested by the similar clinical presentation, ie, elevated temperature, rigidity, delirium, and dysregulation of the autonomic nervous system. Although apparently uncommon, the neuroleptic malignant syndrome has been reported in up to 12.2% of people exposed to neuroleptic medication. Nielsen and Nielsen report the occurrence of the neuroleptic malignant syndrome after a single dose of neuroleptic medication.3
Individuals with mental retardation, autism4 , other pervasive developmental disorders5,6,4 , or other developmental disabilities may be particularly vulnerable to developing catatonia.7,5,6,8
Catatonia apparently has affected some well-known individuals, including Vaslav Nijinsky, the dancer and choreographer.9
Pathophysiology
Catatonia likely represents a heterogeneous group of etiologies. Some hypotheses have been proposed about the pathophysiology of catatonia.
- Deficits in fetal cortical development: Deficits in fetal cortical development may result in schizophrenia and other developmental disorders.10 These deficits in turn likely produce dysfunction in cortical and subcortical glutamatergic pathways, resulting in the symptoms and signs of catatonia.
- Imbalances in the excitatory:inhibitory ratio (EIR) model: Baguley proposes that alterations in interrelated networks at the spinal and brainstem level produce catatonia.11
- Dopaminergic blockade
- Administration of agents that block postsynaptic dopamine receptors is associated with the onset of catatonia in some individuals.
- Agonists of dopamine D1 and D2 receptors relieve catalepsy, a sign of catatonia in rats, suggesting that these agents may be effective pharmacologic interventions. Additionally, the effectiveness of electroconvulsive treatment (ECT) for catatonia suggests that dopaminergic modulation may play a role in the development and amelioration of catatonia.
- Glutamatergic dysfunction
- The effectiveness of amantadine in the treatment of catatonia suggests that at least some individuals with catatonia manifest glutamatergic dysfunction.
- Decreased binding to gamma-aminobutyric acid (GABA)-A receptors in the left sensorimotor cortex has been observed in some subjects with catatonia. The favorable responses of some patients with catatonia to benzodiazepines and zolpidem, agonists of GABA-A, suggest that this is a likely site of dysfunction in some cases of catatonia.12 Potentiation of the action of GABA by benzodiazepines suggests that some individuals with catatonia may have a functional deficit of GABA.
- Dysfunction in neurotransmission of noradrenaline and serotonin
- In inbred rats with catalepsy, Alekhina and colleagues (1993) reported decreases of noradrenaline and increases of serotonin in the striatum and diencephalon.
- Animal models have been developed to study the pathophysiology of catatonia. Uzbay reports that administration of a nonspecific inhibitor of nitric oxide synthase, N(G)-nitro-L-arginine methyl ester (L-NAME), to ethanol-dependent rats being withdrawn from ethanol precipitates catatonia.13 Moreover, L-arginine, a precursor of nitric oxide, does not reverse the catatonia precipitated by L-NAME. Therefore, nitric oxide does not mediate the production of the catatonia. These findings suggest that dysfunction of dopaminergic, serotonergic, and glutamatergic systems may play a role in the production of catatonia in ethanol-dependent rats.
- Frontal anomalies: Kahlbaum noted lesions of the Sylvian fossa and the second and third frontal gyri on autopsy of his patients who died with catatonia.14 These regions modulate executive functions and the inhibition of voluntary acts.
Frequency
United States
The current frequency of catatonia in the United States is unknown. A few studies have noted a decrease in the frequency of catatonia in parts of the United States over the past century. A variety of biases may influence the results of the few epidemiological studies of catatonia.
- In Iowa, a decrease in the prevalence of catatonia was reported from 1920-1966.15
- In Monroe County, New York, the prevalence of catatonic schizophrenia was close to 1 per 1000 residents during the period 1960-1969.16
- In a university hospital in New York in 1994, the incidence of catatonia was 7% of psychiatric inpatients.17 The study was performed at a tertiary care referral hospital known for the treatment of catatonia, so the population is likely not representative of the general population.
Recent anecdotal reports suggest that the prevalence of catatonia is decreasing in the United States.
International
The current frequency of catatonia in international populations is unknown. The few epidemiological studies report vastly different rates. These suggest that the occurrence of catatonia may differ greatly from one location to another. On the other hand, studies suggest that many cases of catatonia may be undiagnosed. Thus, results may be confounded by an ascertainment bias. In other words, in developing countries catatonia may be diagnosed less frequently than in developed countries because clinicians fail to identify catatonia in their patients.
The prevalence of catatonia among inpatients of psychiatric hospitals is 11.4% in Colombia18 , 13.5% in India19 , and 16.9% in Spain20 , and 9.6% in Wales19 . In a forensic psychiatric hospital in France, the prevalence of catatonia was 13.1%.21 In Colombia, treatment apparently is not administered to many patients with catatonia until they have reached an advanced stage of the condition.
Benegal and colleagues report that catatonia appears to be more common in India than in Europe and North America.22
In contrast to those in Colombia, India, and Spain, studies in several other locations suggest that the occurrence of catatonia in the general population decreased dramatically in the past century. In Great Britain, the incidence of catatonia dropped from 6% of admissions to a hospital in the 1850s to 0.5% in the 1950s.23 In a psychiatric clinic in Chile, a decrement in the proportion of patients with schizophrenia who manifest catatonia was observed from 1964-1984. In Finland, the percentage of patients with schizophrenia displaying catatonia decreased from 37% in 1933-1935 to 11% in 1953-1955.24 In Canada, catatonia was present in 10% of inpatient psychiatric admissions in 1993.
Mortality/Morbidity
In Monroe County, New York, the age-adjusted relative risk of death for people with catatonic schizophrenia was thrice that of the county population during the period 1960-1969. However, the risk of death was no higher than for other forms of schizophrenia or other types of mental illness.16
Among 35 young people with catatonia in France aged 12-18 years, most continued to manifest psychiatric morbidity at follow up from 1-10 years. There were 3 deaths, including 2 suicides. Morbidity and mortality in adolescents with catatonia is marked.25
Race
The frequency of catatonia in specific races is unknown. Ungvari and colleagues note the need to investigate the role of ethnic, cultural, and social influences on the development of catatonia.26
Sex
In Monroe County, New York, the female-to-male ratio was 1.3:1 for catatonic schizophrenia and 1.1:1 for all forms of schizophrenia during the period 1960-1969.16 In 1972-1973, a female-to-male ratio of 1.3:1 was observed among inpatients with catatonia admitted to two psychiatric units of a municipal hospital in New York City.27
Age
Although rare in children, catatonia has been reported in adolescents and adults. The prognosis in adolescents is poor. Adolescents with catatonia experience striking morbidity and mortality.25
Clinical
History
Catatonia is a syndrome characterized by the presence of a variety of behavioral and motoric traits. While individuals with catatonia often cannot provide a coherent history, collateral sources of information can often relate relevant historical information. Family members can confirm the presence of typical primary features of catatonia including immobility, stupor, posturing, rigidity, staring, grimacing, and withdrawal. A history of behavioral responses to others usually includes the presence of mutism, negativism, echopraxia, echolalia, waxy flexibility, and withdrawal. A history of stereotypies, mannerisms, and verbigeration is often elicited from people who are close to the patient. Priapism has been reported in a 20-year-old man with paranoid schizophrenia and catatonia.28
The alternative presentation of catatonia is an excited state possibly with impulsivity, combativeness, and autonomic instability. While a history of an excited state should be sought from the family of a person with catatonia, it is often denied by the family. When present, excited episodes are short-lived and may precipitate collapse with exhaustion. An excited state of catatonia is usually associated with bipolar disorder.
During the initial interview of the patient and the family, elicit a history of possible precipitating events, including infection, trauma, and exposure to toxins and other substances.
- In an emergency setting, treatable common causes of catatonia must be rapidly considered and ruled out.
- The emergency physician must quickly consider the presence of neuroleptic malignant syndrome29 , encephalitis, nonconvulsive status epilepticus, and acute psychosis.
- A history of exposure to traditional and atypical neuroleptics must be sought. While malignant neuroleptic syndrome often follows the initiation of neuroleptic therapy or an increase in neuroleptic dose, the exposure to neuroleptics may be minimal in some susceptible individuals. For example, Nielsen and Nielsen report the occurrence of the neuroleptic malignant syndrome after a single dose of neuroleptic medication.3
- A history of encephalitis should be sought. Determine whether the patients has had sudden onset of headache, fever, and deterioration in mental functioning.
- Nonconvulsive status epilepticus must be ruled out (see Epileptic and Epileptiform Encephalopathies and Focal Status Epilepticus). Determine whether the patient has a history of seizures. Determine whether the patient has been prescribed antiepileptic drugs. Determine whether electroencephalograms (EEGs) have been performed and, if so, review the findings.
- Acute psychosis must be ruled out (see Schizophrenia and Alcohol-Related Psychosis). Determine whether the patient has exhibited evidence of delusions and hallucinations. Determine whether the patient has exhibited suicidal or homicidal threats or actions. Record any history of prior psychiatric hospitalization and treatment.
- A history of similar episodes is important to elicit. Determine whether the precipitating events of the earlier episode are present in the current episode. Record any interventions that relieved catatonia previously.
- Catatonia and the related condition, neuroleptic malignant syndrome29 , may follow the administration of neuroleptic medications. Question the patient and family to elicit a history of exposure to neuroleptics and the other substances associated with catatonia (see Differentials and Causes).
- Clinicians must identify comorbid disorders (see Differentials), including schizophrenia, mood disorders, psychological stressors, medical conditions, and obstetrical conditions.
- Catatonia has occurred in patients after treatment with levetiracetam30 and levofloxacin31 .
- Catatonia has occurred in a 55-year-old woman with schizophrenia who was treated with rimonabant, a cannabinoid receptor (CB1) antagonist.32
Physical
Assessment of a person with possible catatonia should include an unstructured observation of the person indirectly as well as a direct interview.
Patients with catatonia exhibit the same general behaviors whether or not the examiner is present. If a patient demonstrates behaviors consistent with catatonia only in the presence of the examiner, then catatonia is unlikely. Instead, conditions characterized by the presence of medical symptoms and signs without physical illness must be considered. Therefore, catatonia that occurs only when the patient is directly observed by the examiner suggests the presence of somatoform disorders, factitious disorders, or malingering. In the movement disorders literature, somatoform disorders, factitious disorders, and malingering exhibiting abnormal movements are commonly classified "psychogenic movement disorders."
Patients with somatoform disorders, such as somatization disorder, conversion disorder, and hypochondriasis, report symptoms and signs that they truly believe despite the absence of confirmation on physical examination. Patients with factitious disorders and malingering deliberately report symptoms and signs that they know to be false. Patients with Munchausen syndrome and other factitious disorders fabricate symptoms and signs because they want to be patients. In Munchausen syndrome by proxy, the parents of the patient, typically an infant unable to communicate, fabricates symptoms and signs in the patient. Unlike patients with factitious disorders, patients with malingering deliberately report false symptoms and signs for specific gain, eg, to obtain disability benefits and to be excused from work.
Because patients with catatonia may be unable to cooperate with the requests of the examiner, specific neurologic signs characteristic of catatonia must be quickly elicited, particularly in emergency settings. In particular, rigidity, gegenhalten, and a grasp reflex are readily apparent signs of catatonia in an emergency setting.
Examination should include checking for cogwheeling at the wrist and elbow. Instruct patients to keep their arms loose and limp (like a dead fish) and move the arms of the patients with varying degrees of force. Rigidity is commonly elicited in the extremities of patients with catatonia. The particular phenomenon of gegenhalten is characteristic in catatonia. Patients with gegenhalten demonstrate increasing resistance to passive movement of the limbs. The patient appears to be deliberately opposing the movements of the examiner.
Test for the presence of a grasp reflex, a secondary feature of catatonia.
- Diagnostic criteria for catatonia include "motoric immobility, excessive motor activity, extreme negativism or mutism, peculiarities of voluntary movement, and echolalia or echopraxia."33 Two of the items are required to diagnose catatonia in schizophrenia and mood disorder. Only one item is required to diagnose catatonia in general medical conditions.
- The predominant activity level of the individual is either markedly slow or extremely high. The behavior of the patients may shift suddenly and unpredictably from one state to the other.
- In the excited state, people with catatonia may injure themselves and assault others. They may also experience autonomic instability manifested by hyperthermia, tachycardia, and hypertension. Individuals in the excited state are at risk of collapse from exhaustion.
- In the immobile state, the individual may not move. Akinesia and stupor are synonyms for this state. The patient may appear unresponsive to external stimuli. He or she may be unable to eat, and may die unless parenteral nutrition and fluids are administered. People with catatonia may exhibit catalepsy, the persistent maintenance of spontaneous or imposed postures.
- Negativistic phenomena are observed typically in catatonia. These include gegenhalten and mitgehen. In gegenhalten, the patient resists movement of his or her extremities by the examiner. Mitgehen is characterized by the patient moving in the direction of a slight push from the examiner in spite of the command to remain still. The physical examination should include tests for these. Motor persistence, the maintenance of a posture when commanded to not maintain the posture, is a manifestation of catatonia that is associated with right hemispheric strokes. Other negativistic phenomena are withdrawal from all usual activities and refusal to eat.
- In addition to negativistic phenomena, individuals with catatonia may display other behaviors indicating inability to appropriately modulate the inhibition of impulses. For example, patients with catatonia may demonstrate automatic obedience, the performance of tasks at the command of the examiner even though the tasks are inappropriate or dangerous.
- Peculiarities of movement are common in catatonia. Stereotypies, repetitive performing of apparently meaningless activities, are common. These may take the form of repetitive actions or sounds. Verbigeration refers to the presence of repetitive apparently meaningless utterances.
- Common motor stereotypies include nose wrinkling; repetitive movements of the mouth and the jaw; repetitive eye movements; repetitive tapping of the foot, the finger, or the hand; and repetitive abdomen patting, shoulder shrugging, or body rocking. Other movements associated with catatonia include mannerisms, postures, gaze fixation, and choreoathetoid movements of the trunk and extremities.
- Verbigeration, or verbal stereotypies, include sniffing, clicking, snorting, and nonmeaningful sounds.
- Patients with catatonia may also display preservation, the inappropriate repetition of acts.
- Echophenomena are typical in catatonia. Echolalia, the repetition of the words spoken by the examiner, and echopraxia, the repetition of the motor acts performed by the examiner, are common.
- In France, the inappropriately formal use of vous [ie, the formal form of "you"] to address the patient's spouse has been identified as a finding in catatonia. The informal use of tu [ie, the informal form of "you"] is appropriate to address the patient's spouse.
- Peralta and Cuesta hypothesized that a sufficient condition to diagnose catatonia is the presence of 3 of the classic motor signs of catatonia as follows: immobility/stupor, mutism, negativism, oppositionism, posturing, catalepsy, automatic obedience, echophenomena, rigidity, verbigeration, and withdrawal.34
- Clinicians must identify comorbid disorders including schizophrenia, mood disorders, and neurological and medical conditions (see Causes).
- Neuroleptic-induced parkinsonism may also be associated with catatonia.
- The presence of severe muscle rigidity, autonomic dysregulation, and hyperthermia suggests the possibility of a neuroleptic malignant syndrome.
- Headache, fever, and a stiff neck in an acutely ill patient suggest the presence of encephalitis. See Encephalitis for further information about the physical examination of patients with encephalitis.
- Acute psychosis is suggested by the presence of hallucinations, delusions, and suicidal and homicidal threats and behaviors.
Causes
To facilitate assessment of the cause of catatonia, associated conditions are categorized as neurological, psychiatric, psychological, medical, and obstetrical.
Causes of Catatonia by Category
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Table
| Category | Causes |
|---|---|
| Neurological conditions | Neuroleptic malignant syndrome 29 * Administration of agents that block postsynaptic dopamine receptors† Administration of sibutramine 35 Withdrawal of lorazepam and other sedatives Akinetic-rigid syndrome Arachnoid cyst in right parietal region Astrocytoma Atrophy of left amygdala 36 Autistic disorder 37, 5, 6, 38, 39, 40, 41, 4, 42 Basilar artery thrombosis Bilateral hemorrhagic lesions of temporal lobes Cerebellar catalepsy Cerebral hemorrhage Cerebral infarct Cerebrovascular disease Cortical venous thrombosis Central pontine myelinolysis Cortical basal ganglionic degeneration Dystonia Encephalitis (herpes, Trypanosoma cruzi)‡ Encephalopathy (Borrelia burgdorferi, HIV infection, Wernicke encephalopathy) Familial fatal insomnia 43 Fibromuscular dysplasia with dissection of basilar artery Frontal lobotomy Head injury Huntington disease Hydrocephalus Hypopituitarism secondary to postpartum hemorrhage Idiopathic recurring stupor Inherited neurometabolic disorders Locked-in syndrome Meningitis, tuberculous Meningoencephalitis Multiple sclerosis 44, 45 Neurosyphilis Nonconvulsive status epilepticus§ Pervasive developmental disorders 5, 6, 41 Pallidoluysian atrophy Paraneoplastic encephalitis 46 Parkinsonism Postencephalitic parkinsonism Progressive multifocal leukoencephalopathy Progressive supranuclear palsy Schizencephaly Seizures (complex with partial symptomatology) Stiff-man syndrome Stroke Stupor Subarachnoid hemorrhage Subdural hematoma Substance intoxication (alcohol, disulfiram, organic fluorides, phencyclidine) Subthalamic mesencephalic tumor Surgical removal of cerebellar tumor Tay-Sachs disease Temporal lobe epilepsy Tuberous sclerosis Tumors (corpus callosum, glioma of third ventricle, supraventricular diffuse pinealoma) Vegetative state Von Economo encephalitis Wilson disease |
| Psychiatric conditions | Acute stress disorder Anorexia nervosa Autistic disorder 4 Brief reactive psychosis with catatonia Conversion disorder Hysteria Major depression, single episode with catatonic features Mood disorders Neuroleptic malignant syndrome 29 Posttraumatic stress disorder Schizophrenia Substance intoxication (3,4-methylenedioxymethamphetamine [ie, "ecstasy"], alcohol, amphetamine, phencyclidine, substance withdrawal, hypnotic-sedative, lorazepam) |
| Psychological conditions | Immigration Rejection of a love offer by beloved Visit to relative in another country |
| Medical conditions | AIDS Acute intermittent porphyria Addison disease Bacterial septicemia Bronchorrhea Carcinoid tumors Diabetic ketoacidosis Encephalopathy (hepatic, HIV infection related, Wernicke) Fever of unknown cause Heat stroke Hepatic failure Hereditary coproporphyria Homocystinuria Hypercalcemia Hyperparathyroidism Hyperthyroidism Hyponatremia Hypothermia Intestinal atony Malaria Neuroleptic malignant syndrome 29 Poisoning (carbon monoxide, tetraethyl lead) Renal failure Substance intoxication (alcohol, cyclosporine, disulfiram, organic fluorides, phencyclidine) Syndrome of inappropriate antidiuretic hormone (SIADH) Syphilis Systemic lupus erythematosus Thermal injury Thrombotic thrombocytopenic purpura Tuberculosis Typhoid fever Uremia Von Economo encephalitis |
| Obstetrical conditions | Hypopituitarism secondary to postpartum hemorrhage |
| Category | Causes |
|---|---|
| Neurological conditions | Neuroleptic malignant syndrome 29 * Administration of agents that block postsynaptic dopamine receptors† Administration of sibutramine 35 Withdrawal of lorazepam and other sedatives Akinetic-rigid syndrome Arachnoid cyst in right parietal region Astrocytoma Atrophy of left amygdala 36 Autistic disorder 37, 5, 6, 38, 39, 40, 41, 4, 42 Basilar artery thrombosis Bilateral hemorrhagic lesions of temporal lobes Cerebellar catalepsy Cerebral hemorrhage Cerebral infarct Cerebrovascular disease Cortical venous thrombosis Central pontine myelinolysis Cortical basal ganglionic degeneration Dystonia Encephalitis (herpes, Trypanosoma cruzi)‡ Encephalopathy (Borrelia burgdorferi, HIV infection, Wernicke encephalopathy) Familial fatal insomnia 43 Fibromuscular dysplasia with dissection of basilar artery Frontal lobotomy Head injury Huntington disease Hydrocephalus Hypopituitarism secondary to postpartum hemorrhage Idiopathic recurring stupor Inherited neurometabolic disorders Locked-in syndrome Meningitis, tuberculous Meningoencephalitis Multiple sclerosis 44, 45 Neurosyphilis Nonconvulsive status epilepticus§ Pervasive developmental disorders 5, 6, 41 Pallidoluysian atrophy Paraneoplastic encephalitis 46 Parkinsonism Postencephalitic parkinsonism Progressive multifocal leukoencephalopathy Progressive supranuclear palsy Schizencephaly Seizures (complex with partial symptomatology) Stiff-man syndrome Stroke Stupor Subarachnoid hemorrhage Subdural hematoma Substance intoxication (alcohol, disulfiram, organic fluorides, phencyclidine) Subthalamic mesencephalic tumor Surgical removal of cerebellar tumor Tay-Sachs disease Temporal lobe epilepsy Tuberous sclerosis Tumors (corpus callosum, glioma of third ventricle, supraventricular diffuse pinealoma) Vegetative state Von Economo encephalitis Wilson disease |
| Psychiatric conditions | Acute stress disorder Anorexia nervosa Autistic disorder 4 Brief reactive psychosis with catatonia Conversion disorder Hysteria Major depression, single episode with catatonic features Mood disorders Neuroleptic malignant syndrome 29 Posttraumatic stress disorder Schizophrenia Substance intoxication (3,4-methylenedioxymethamphetamine [ie, "ecstasy"], alcohol, amphetamine, phencyclidine, substance withdrawal, hypnotic-sedative, lorazepam) |
| Psychological conditions | Immigration Rejection of a love offer by beloved Visit to relative in another country |
| Medical conditions | AIDS Acute intermittent porphyria Addison disease Bacterial septicemia Bronchorrhea Carcinoid tumors Diabetic ketoacidosis Encephalopathy (hepatic, HIV infection related, Wernicke) Fever of unknown cause Heat stroke Hepatic failure Hereditary coproporphyria Homocystinuria Hypercalcemia Hyperparathyroidism Hyperthyroidism Hyponatremia Hypothermia Intestinal atony Malaria Neuroleptic malignant syndrome 29 Poisoning (carbon monoxide, tetraethyl lead) Renal failure Substance intoxication (alcohol, cyclosporine, disulfiram, organic fluorides, phencyclidine) Syndrome of inappropriate antidiuretic hormone (SIADH) Syphilis Systemic lupus erythematosus Thermal injury Thrombotic thrombocytopenic purpura Tuberculosis Typhoid fever Uremia Von Economo encephalitis |
| Obstetrical conditions | Hypopituitarism secondary to postpartum hemorrhage |
*See Neuroleptic Malignant Syndrome, Neuroleptic Malignant Syndrome, and Neuroleptic Malignant Syndrome.
† The administration of agents that block postsynaptic dopamine receptors is associated with the onset of catatonia in some individuals.
‡See Encephalitis.
§See Epileptic and Epileptiform Encephalopathies and Focal Status Epilepticus.
- Neuroleptic malignant syndrome29 : Neuroleptic malignant syndrome is characterized by introduction or increased dose of a neuroleptic medication, a temperature greater than 38 degrees centigrade, and heart rate greater than 100 beats per minute or diastolic blood pressure greater than 100 mm Hg. The triad of fever, tachycardia, and rigidity is typical of the syndrome, which is associated with death in about one fifth of cases.
- Latah betul or "real latah" or "true latah" is a phenomenon present in Malaysia characterized by the apparent loss of control over behavior and by echolalia, echopraxia, and automatic obedience.
- Winzeler surveyed ethnic groups in different regions of Malaysia to present demographic and epidemiologic data about the condition. None of the individuals under 10 years of age exhibited latah in any of the groups examined. Latah was much more common in women. Mature women were the most common group to exhibit latah. People who developed latah exhibited it for the rest of their lives. People who developed latah in Malaysia often associated the onset with frightening experiences, both in life and in dreams, and with sorcery.47 Simons48 and Tanner and Chamberland49 have published videotapes of individuals with latah to facilitate its recognition by individuals of other cultures who are unfamiliar with the condition.
- The occurrence of latah betul in older women in particular cultures in Southeast Asia suggests that some individuals in the affected ethnic groups may have a vulnerability to develop the condition. This is reminiscent of other neuropsychiatric disorders with a genetic basis. The histories of persons with latah betul suggest that extreme stress may precipitate the onset of the disorder in some individuals. Thus, environmental influences may facilitate the development of latah betul in those with an inborn predisposition to express the phenotype of latah betul.
- Evaluation of people with latah betul by clinicians experienced with movement disorders may facilitate the application of the standard nomenclature for movement disorders, mental disorders, and other medical conditions to categorize latah betul. The published reports of latah betul suggest the diagnosis of catatonia. Research by individuals trained in the diagnosis of neuropsychiatric disorders will facilitate the understanding of latah betul and its place in a lexicon of diseases.
More on Catatonia |
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References
Ungvari GS, Caroff SN, Gerevich J. The Catatonia Conundrum: Evidence of Psychomotor Phenomena as a Symptom Dimension in Psychotic Disorders. Schizophr Bull. Sep 23 2009;[Medline].
Ungvari GS, Goggins W, Leung SK, Lee E, Gerevich J. Schizophrenia with prominent catatonic features ('catatonic schizophrenia') III. Latent class analysis of the catatonic syndrome. Prog Neuropsychopharmacol Biol Psychiatry. Feb 1 2009;33(1):81-5. [Medline].
Nielsen N, Nielsen NB. [Malignant neuroleptic syndrome in a 15-year old girl after a single injection of a high-dose neuroleptic]. Ugeskr Laeger. Aug 5 1991;153(32):2239-40. [Medline].
Kannabiran M, McCarthy J. The mental health needs of people with autism spectrum disorders. Psychiatry. Oct 2009;8(10):398-401.
Brasic JR, Zagzag D, Kowalik S, et al. Clinical manifestations of progressive catatonia. German Journal of Psychiatry [serial online]. 2000;[Full Text].
Brasic JR, Zagzag D, Kowalik S, et al. Progressive catatonia. Psychol Rep. Feb 1999;84(1):239-46. [Medline].
Gaind GS, Rosebush PI, Mazurek MF. Lorazepam treatment of acute and chronic catatonia in two mentally retarded brothers. J Clin Psychiatry. Jan 1994;55(1):20-3. [Medline].
Hare DJ, Malone C. Catatonia and autistic spectrum disorders. Autism. Jun 2004;8(2):183-95. [Medline].
Ostwald P. The "God of the dance": treating Nijinsky's manic excitement and catatonia. Hosp Community Psychiatry. Oct 1994;45(10):981-5. [Medline].
Lafargue T, Brasic J. Neurodevelopmental hypothesis of schizophrenia: a central sensory disturbance. Med Hypotheses. Oct 2000;55(4):314-8. [Medline].
Baguley IJ. The excitatory:inhibitory ratio model (EIR model): An integrative explanation of acute autonomic overactivity syndromes. Med Hypotheses. 2008;70(1):26-35. [Medline].
Coconcea C. Zolpidem in treatment resistant catatonia: 2 case reports and literature review [abstract]. Schizophrenia Res. 2008;98:134.
Uzbay IT. L-NAME precipitates catatonia during ethanol withdrawal in rats. Behav Brain Res. Feb 15 2001;119(1):71-6. [Medline].
Kahlbaum KL. Catatonia. Baltimore, Md: Johns Hopkins University Press; 1874/1973.
Morrison JR. Changes in subtype diagnosis of schizophrenia: 1920-1966. Am J Psychiatry. Jun 1974;131(6):674-7. [Medline].
Guggenheim FG, Babigian HM. Catatonic schizophrenia: epidemiology and clinical course. A 7-year register study of 798 cases. J Nerv Ment Dis. Apr 1974;158(4):291-305. [Medline].
Fink M, Bush G, Francis A. Catatonia: a treatable disorder, occasionally recognized. Directions in Psychiatry. 1993;13(3):1-8.
Escobar R, Rios A, Montoya ID, et al. Clinical and cerebral blood flow changes in catatonic patients treated with ECT. J Psychosom Res. Dec 2000;49(6):423-9. [Medline].
Chalasani P, Healy D, Morriss R. Presentation and frequency of catatonia in new admissions to two acute psychiatricadmission units in India and Wales. Psychol Med. Nov 2005;35(11):1667-75. [Medline].
Peralta V, Cuesta MJ, Serrano JF, Mata I. The Kahlbaum syndrome: a study of its clinical validity, nosological status, and relationship with schizophrenia and mood disorder. Compr Psychiatry. Jan-Feb 1997;38(1):61-7. [Medline].
Vorspan F, Cornic F, Mathis D, Cohen D, Lepine JP. Catatonia in a French forensic psychiatric facility: Frequency, prognosis and treatment [abstract]. European Psychiatry. 2008;23:S332-S333.
Benegal V, Hingorani S, Khanna S. Idiopathic catatonia: validity of the concept. Psychopathology. 1993;26(1):41-6. [Medline].
Johnson J. Catatonia: the tension insanity. Br J Psychiatry. Jun 1993;162:733-8. [Medline].
Rogers D. Catatonia: a contemporary approach. J Neuropsychiatry Clin Neurosci. Summer 1991;3(3):334-40. [Medline].
Cornic F, Consoli A, Tanguy ML, Bonnot O, Périsse D, Tordjman S, et al. Association of adolescent catatonia with increased mortality and morbidity: evidence from a prospective follow-up study. Schizophr Res. Sep 2009;113(2-3):233-40. [Medline].
Ungvari GS, Leung SK, Ng FS, et al. Schizophrenia with prominent catatonic features ('catatonic schizophrenia'): I. Demographic and clinical correlates in the chronic phase. Prog Neuropsychopharmacol Biol Psychiatry. Jan 2005;29(1):27-38. [Medline].
Abrams R, Taylor MA. Catatonia. A prospective clinical study. Arch Gen Psychiatry. May 1976;33(5):579-81. [Medline].
Fischel T, Krivoy A, Brenner I, Weizman A. Priapism as an unusual manifestation of catatonia: a case report. Prog Neuropsychopharmacol Biol Psychiatry. Apr 30 2009;33(3):570. [Medline].
Vesperini S, Papettia F, Pringuey D. Existe-t-il un lien entre catatonie et syndrome malin des neuroleptiques ? [Are catatonia and neuroleptic malignant syndrome related conditions?]. L'Encéphale. 2009.
Chouinard MJ, Nguyen DK, Clement JF, Bruneau MA. Catatonia induced by levetiracetam. Epilepsy Behav. Feb 2006;8(1):303-7. [Medline].
Youssef NA, Benazzi F, Desan PH. Levofloxacin-induced catatonia. Prog Neuropsychopharmacol Biol Psychiatry. Jun 15 2009;33(4):741-2. [Medline].
Reddy NN, Rao NP, Venkatasubramanian G, Arasappa R, Behere RV, Divakaran A, et al. Rimonabant-induced catatonia in schizophrenia: A case report. Obesity Research & Clinical Practice. Nov 2009;3 (4):237-239.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Peralta V, Cuesta MJ. Motor features in psychotic disorders. II. Development of diagnostic criteria for catatonia. Schizophr Res. Mar 1 2001;47(2-3):117-26. [Medline].
Lee J, Teoh T, Lee TS. Catatonia and psychosis associated with sibutramine: a case report and pathophysiologic correlation. J Psychosom Res. Jan 2008;64(1):107-9. [Medline].
Neto B. Catatonia with left temporal lesion on MRI: crossing borders. European Psychiatry. 2009;24 supplement 1:S727.
Wachtel L. Catatonia in autism: Etiology, incidence and treatment [abstract]. European Psychiatry. 2008;23:S402-S402.
Wachtel LE, Contrucci-Kuhn SA, Griffin M, Thompson A, Dhossche DM, Reti IM. ECT for self-injury in an autistic boy. Eur Child Adolesc Psychiatry. Jul 2009;18(7):458-63. [Medline].
Wachtel LE, Griffin M, Reti IM. Electroconvulsive Therapy in a Man With Autism Experiencing Severe Depression, Catatonia, and Self-Injury. J ECT. May 27 2009;[Medline].
Dhossche DM, Reti IM, Wachtel LE. Catatonia and autism: a historical review, with implications for electroconvulsive therapy. J ECT. Mar 2009;25(1):19-22. [Medline].
Wachtel LE. Catatonia in autism and other neurodevelopmental disorders. European Psychiatry. 2009;24, Supplement 1:S737.
Kakooza-Mwesige A, Wachtel LE, Dhossche DM. Catatonia in autism: implications across the life span. Eur Child Adolesc Psychiatry. Sep 2008;17(6):327-35. [Medline].
Gonzalez Oliveros R, Saracibar N, Gutierrez M, DNA Bank UPV/EHU, Munon T, Gonzalez-Pinto A. Catatonia due to a prion familial disease. Schizophrenia Research. Mar 2009;108, Issues 1-3:309-10.
Scozzafava J, Aladdin Y, Jickling G, Asdaghi N, Hussain M, Giuliani F. Stuporous catatonia and white matter lesions. J Clin Neurosci. Oct 2009;16(10):1328, 1386. [Medline].
Blanc F, Berna F, Fleury M, Lita L, Ruppert E, Ferriby D, et al. [Inaugural psychotic events in multiple sclerosis?]. Rev Neurol (Paris). Sep 5 2009;[Medline].
Le Foll J, Pelletier A. Symptômes psychiatriques d'une encéphalite paranéoplasique à anticorps antirécepteurs NMDA : à propos d'un cas [Psychiatric symptoms of a paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis: A case report]. L'Encéphale. 2009.
Winzeler RL. Latah in Southeast Asia: the history and ethnography of a culture-bound syndrome. Cambridge, Great Britain: Cambridge University Press; 1995.
Simons RC. Latah: a culture-specific elaboration of the startle reflex [film]. Bloomington, Indiana: Indiana University Audiovisual Center; 1983.
Tanner CM, Chamberland J. Latah in Jakarta, Indonesia. Mov Disord. May 2001;16(3):526-9. [Medline].
Brasic JR, Barnett JY, Will MV, Nadrich RH, Sheitman BB, Ahmad R, et al. Dyskinesias differentiate autistic disorder from catatonia. CNS Spectr. Dec 2000;5(12):19-22. [Medline].
Brasic JR, Andrews SR, Housain B, Alexander M, Mohamed M. Characterization of zaghrouta, an expression of happiness in the Middle East, a component of the differential diagnosis of psychogenic disorders. 2nd International Conference on Psychogenic Movement Disorders and Other Conversion Disorders. Apr 2008;78-79.
Brasic JR, Alexander M, Mohamed M. Differentiation of zaghrouta, an expression of happiness by women in the Middle East, from medical disease. Southern Medical Journal. Oct 2003;96(Suppl10):S35.
Brelinski L, Cottencin O, Guardia D, Anguill JD, Queyrel V, Hatron PY. Catatonia and systemic lupus erythematosus: a clinical study of three cases. Gen Hosp Psychiatry. Jan-Feb 2009;31(1):90-2. [Medline].
Kalivas KK, Bourgeois JA. Catatonia after liver and kidney transplantation. Gen Hosp Psychiatry. Mar-Apr 2009;31(2):196-8. [Medline].
Haouzir S, Lemoine X, Desbordes M, Follet M, Meunier C, Baarir Z, et al. The role of coagulation marker fibrin D-dimer in early diagnosis of catatonia. Psychiatry Res. Jun 30 2009;168(1):78-85. [Medline].
Askenazy F, Dor E, Benoit M, Dupuis G, Serret S, Myquel M, et al. Catatonie chez une adolescente de 14 ans : traitement par clorazépam et carbamazépine et évolution à dix ans [Catatonia in a 14 year-old girl: Treatment with clonazepam and carbamazepine, a 10-year follow-up]. L'Encéphale. 2009.
Chang CH, Hsiao YL, Hsu CY, Chen ST. Treatment of catatonia with olanzapine: a case report. Prog Neuropsychopharmacol Biol Psychiatry. Nov 13 2009;33(8):1559-60. [Medline].
Chanpattana W, Kramer BA, Kunigiri G, Gangadhar BN, Kitphati R, Andrade C. A Survey of the Practice of Electroconvulsive Therapy in Asia. J ECT. May 13 2009;[Medline].
Chanpattana W, Kramer BA, Kunigiri G, Gangadhar BN, Kitphati R, Andrade C. A Survey of the Practice of Electroconvulsive Therapy in Asia. J ECT. May 13 2009;[Medline].
Chanpattana W. A survey of the practice of electroconvulsive therapy in Asia. European Psychiatry. 2009;24 Supplement 1:S770.
Wachtel LE, Kahng S, Dhossche DM, Cascella N, Reti IM. ECT for catatonia in an autistic girl. Am J Psychiatry. Mar 2008;165(3):329-33. [Medline].
Consoli A, Boulicot V, Cornic F, Fossati P, Barbeau M, Cohen D. Moderate clinical improvement with maintenance ECT in a 17-year-old boy with intractable catatonic schizophrenia. Eur Child Adolesc Psychiatry. Apr 2009;18(4):250-4. [Medline].
Slooter AJ, Braun KP, Balk FJ, et al. Electroconvulsive therapy for malignant catatonia in childhood. Pediatr Neurol. Mar 2005;32(3):190-2. [Medline].
Rhoads JC, Votolato NA, Young JL, Gilchrist RH. The successful use of right unilateral ultra-brief pulse electroconvulsive therapy in an adolescent with catatonia. Brain Stimulation. 2009.
Gupta A, Dhir A, Kumar A, Kulkarni SK. Protective effect of cyclooxygenase (COX)-inhibitors against drug-induced catatonia and MPTP-induced striatal lesions in rats. Pharmacol Biochem Behav. Dec 2009;94(2):219-26. [Medline].
Krivoy A, Weizman A, Kimchi-Nesher S, Zemishlany Z, Fischel T. Recurrnet [sic] catatonia: Fluctuating between psychotic and catatonic dimensions [abstract]. European Psychiatry. 2008;23:S328-S329.
Bush G, Fink M, Petrides G, et al. Catatonia. II. Treatment with lorazepam and electroconvulsive therapy. Acta Psychiatr Scand. Feb 1996;93(2):137-43. [Medline].
Fink M. Treating neuroleptic malignant syndrome as catatonia. J Clin Psychopharmacol. Feb 2001;21(1):121-2. [Medline].
Huang TL, Hung YY. Lorazepam reduces the serum brain-derived neurotrophic factor level in schizophrenia patients with catatonia. Prog Neuropsychopharmacol Biol Psychiatry. Feb 1 2009;33(1):158-9. [Medline].
Carroll BT. Kahlbaum's catatonia revisited. Psychiatry Clin Neurosci. Oct 2001;55(5):431-6. [Medline].
Bonnot O, Tanguy ML, Consoli A, Cornic F, Graindorge C, Laurent C, et al. Does catatonia influence the phenomenology of childhood onset schizophrenia beyond motor symptoms?. Psychiatry Res. Apr 15 2008;158(3):356-62. [Medline].
Lahutte B, Cornic F, Bonnot O, Consoli A, An-Gourfinkel I, Amoura Z. Multidisciplinary approach of organic catatonia in children and adolescents may improve treatment decision making. Prog Neuropsychopharmacol Biol Psychiatry. Mar 7 2008;[Medline].
Abdullah S. Diagnostic guidelines and clinical realities. In: Synapse: The West Hudson Psychiatric Society Newsletter. Vol 3, 6, 7. 2002 July-August. [Full Text].
Adams RD, Victor M. Principles of Neurology. 5th ed. New York, NY: McGraw-Hill; 1993.
Akhtar S, Ahmad H. Ciprofloxacin-induced catatonia. J Clin Psychiatry. Mar 1993;54(3):115-6. [Medline].
Akhtar S, Buckman J. The differential diagnosis of mutism: a review and a report of three unusual cases. Dis Nerv Syst. Jul 1977;38(7):558-63. [Medline].
Ambelas A. Preschizophrenics: adding to the evidence, sharpening the focus. Br J Psychiatry. Mar 1992;160:401-4. [Medline].
Amore M, Montanari M. [Neuroleptic malignant syndrome and related conditions]. Minerva Psichiatr. Oct-Dec 1992;33(4):259-83. [Medline].
Anfinson TJ, Cruse J. SIADH associated with catatonia: its resolution with ECT. Psychosomatics. 1995;36(2):212.
Arunodaya GR, Vani S, Shankar SK, et al. Fibromuscular dysplasia with dissection of basilar artery presenting as "locked-in-syndrome". Neurology. Jun 1997;48(6):1605-8. [Medline].
Ayd FJ Jr. Catatonia. Psychiatric Times;1994:31.
Barnes MP, Saunders M, Walls TJ, et al. The syndrome of Karl Ludwig Kahlbaum. J Neurol Neurosurg Psychiatry. Sep 1986;49(9):991-6. [Medline].
Benson DF, Cummings JL. Agraphia. In: Vinken PJ, Bruyn GW, Klawans HL, eds. Handbook of Clinical Neurology. Vol 1. Amsterdam, Netherlands: Elsevier Science; 1985:457-472.
Bernstein L, Levin R. Catatonia responsive to intravenous lorazepam in a patient with cyclosporine neurotoxicity and hypomagnesemia. Psychosomatics. Jan-Feb 1993;34(1):102-3. [Medline].
Bhatia MS, Salrabh, Shome S, Joshi G. Recurrent catatonia in Sheehan's syndrome (a case report). Indian J Med Sci. Feb 1994;48(2):43, 45. [Medline].
Black KJ, Kilzieh N. Severe imipramine-induced myoclonus in a patient with psychotic bipolar depression, catatonia, and schizencephaly. Ann Clin Psychiatry. Mar 1994;6(1):45-9. [Medline].
Blumer D. Catatonia and the neuroleptics: psychobiologic significance of remote and recent findings. Compr Psychiatry. Jul-Aug 1997;38(4):193-201. [Medline].
Bodkin JA. Emerging uses for high-potency benzodiazepines in psychotic disorders. J Clin Psychiatry. May 1990;51 Suppl:41-6; discussion 50-3. [Medline].
Boeve BF, Rummans TA, Philbrick KL, Callahan MJ. Electrocardiographic and echocardiographic changes associated with malignant catatonia. Mayo Clin Proc. Jul 1994;69(7):645-50. [Medline].
Bogousslavsky J, Ghika J. Catalepsy after stroke. Neurology. Apr 25 2000;54(8):1711-2. [Medline].
Boronow J, Stoline A, Sharfstein SS. Refusal of ECT by a patient with recurrent depression, psychosis, and catatonia. Am J Psychiatry. Sep 1997;154(9):1285-91. [Medline].
Brasic JR, Barnett JY, Will MV, et al. Dyskinesias differentiate autistic disorder from catatonia. CNS Spectrums. 2000;5(12):19-22.
Brown MM, Swash M. Systemic lupus erythematosus. In: Vinken PJ, Bruyn GW, Klawans HL, eds. Handbook of Clinical Neurology, Revised Series: Vascular Diseases. Amsterdam, Netherlands: Elsevier Science; 1989:369-385.
Brust JC. Coma. In: Rowland LP, ed. Merritt's Textbook of Neurology. 8th ed. Philadelphia: Lea & Febiger; 1989:21-28.
Burruss JW, Chacko RC. Episodically remitting akinetic mutism following subarachnoid hemorrhage. J Neuropsychiatry Clin Neurosci. Winter 1999;11(1):100-2. [Medline].
Bush G, Fink M, Petrides G, et al. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. Feb 1996;93(2):129-36. [Medline].
Bush G, Francis AJ, Fink M. Identification and classification of catatonia. San Francisco: American Psychiatric Association; 1993:184-185.
Carroll BT. Catatonia due to mixed sedative withdrawal. J Neuropsychiatry Clin Neurosci. Spring 1997;9(2):303-4. [Medline].
Carroll BT, Boutros NN. Clinical electroencephalograms in patients with catatonic disorders. Clin Electroencephalogr. Jan 1995;26(1):60-4. [Medline].
Carroll BT, Spetie L. Catatonia on the consultation-liaison service: a replication study. Int J Psychiatry Med. 1994;24(4):329-37. [Medline].
Carroll BT, Taylor RE. The nondichotomy between lethal catatonia and neuroleptic malignant syndrome. J Clin Psychopharmacol. Jun 1997;17(3):235-8. [Medline].
Castillo E, Rubin RT, Holsboer-Trachsler E. Clinical differentiation between lethal catatonia and neuroleptic malignant syndrome. Am J Psychiatry. Mar 1989;146(3):324-8. [Medline].
Chang GY. Arm levitation in progressive supranuclear palsy. Neurology. Feb 8 2000;54(3):774; discussion 774-5. [Medline].
Chaves-Carballo E. Detection of inherited neurometabolic disorders. A practical clinical approach. Pediatr Clin North Am. Aug 1992;39(4):801-20. [Medline].
Chern CH, Tsai WJ. [Acute amphetamine intoxication with catatonia: a case report]. Zhonghua Yi Xue Za Zhi (Taipei). Apr 1993;51(4):322-7. [Medline].
Cizadlo BC, Wheaton A. Case study: ECT treatment of a young girl with catatonia. J Am Acad Child Adolesc Psychiatry. Mar 1995;34(3):332-5. [Medline].
Climo LH. Treatment-resistant catatonic stupor and combined lithium-neuroleptic therapy: a case report. J Clin Psychopharmacol. Jun 1985;5(3):166-70. [Medline].
Cools AR. Clinical neuropharmacology of the basal ganglia. In: Vinken PJ, Bruyn GW, Klawans HL, eds. Handbook of Clinical Neurology, Extrapyramidal Disorders. Vol 5. Amsterdam, Netherlands: Elsevier Science; 1986:47-63.
Cooper AF, Schapira K. Case report: depression, catatonic stupor, and EEG changes in hyperparathyroidism. Psychol Med. Nov 1973;3(4):509-15. [Medline].
Cottencin O, Debien C, Vaiva G, et al. Catatonia and liver transplant. Psychosomatics. Jul-Aug 2002;43(4):338-9. [Medline].
Davis EJ, Borde M. Wilson's disease and catatonia. Br J Psychiatry. Feb 1993;162:256-9. [Medline].
DeQuardo JR, Liberzon I, Silk KR. Buproprion, ECT, and dopaminergic overdrive. Am J Psychiatry. 1991;148:1102.
Devanand DP, Shapira B, Petty F, et al. Effects of electroconvulsive therapy on plasma GABA. Convuls Ther. Mar 1995;11(1):3-13. [Medline].
Dhossche D, Bouman N. Catatonia in children and adolescents. J Am Acad Child Adolesc Psychiatry. Jul 1997;36(7):870-1. [Medline].
Dose M. Neuroleptic-induced pseudo-catatonia. Pharmacopsychiatry. Nov 2001;34(6):262-4. [Medline].
Duggal HS. Risperidone treatment of febrile catatonia in first-episode psychosis [letter]. Gen Hosp Psychiatry. Jan-Feb 2005;27(1):80-1. [Medline].
Duggal HS, Singh I. Drug-induced catatonia. Drugs Today (Barc). Sep 2005;41(9):599-607. [Medline].
Ebadi M, Pfeiffer RF, Murrin LC. Pathogenesis and treatment of neuroleptic malignant syndrome. Gen Pharmacol. 1990;21(4):367-86. [Medline].
Figiel GS. ECT and delirium in Parkinson's disease. Am J Psychiatry. Dec 1992;149(12):1759; author reply 1759-60. [Medline].
Fink M. Administrative problems limiting electroconvulsive therapy. Br J Psychiatry. Jun 1994;164(6):850-1. [Medline].
Fink M. Catatonia in DSM-IV. Biol Psychiatry. Oct 1 1994;36(7):431-3. [Medline].
Fink M. Catatonia: syndrome or schizophrenia subtype? Recognition and treatment. J Neural Transm. 2001;108(6):637-44. [Medline].
Fink M. Failure to use ECT in treatment of catatonia. Am J Psychiatry. Jan 1992;149(1):145-6. [Medline].
Fink M. Lethal catatonia, neuroleptic malignant syndrome, and catatonia: a spectrum of disorders. J Clin Psychopharmacol. 1997;17:237.
Fink M. Treat NMS as catatonia. Psychiatric Times. 1995;12(3):34.
Fink M, Taylor MA. Catatonia: a separate category in DSM-IV?. Integrative Psychiatry. 1991;7:2-10.
Fink M, Taylor MA. Neuroleptic malignant syndrome is malignant catatonia, warranting treatments efficacious for catatonia. Prog Neuropsychopharmacol Biol Psychiatry. Aug 30 2006;30(6):1182-3; author reply 1184-5. [Medline].
Fisher CM. 'Catatonia' due to disulfiram toxicity. Arch Neurol. Jul 1989;46(7):798-804. [Medline].
Fleischhacker WW, Unterweger B, Kane JM, Hinterhuber H. The neuroleptic malignant syndrome and its differentiation from lethal catatonia. Acta Psychiatr Scand. Jan 1990;81(1):3-5. [Medline].
Ford RA. The psychopathology of echophenomena. Psychol Med. Aug 1989;19(3):627-35. [Medline].
Francis A, Divadeenam KM, Bush G, Petrides G. Consistency of symptoms in recurrent catatonia. Compr Psychiatry. Jan-Feb 1997;38(1):56-60. [Medline].
Franzek E, Sperling W, Stober G, et al. [The early childhood form of negativistic catatonia]. Nervenarzt. May 1993;64(5):324-7. [Medline].
Fricchione G. Catatonia: a new indication for benzodiazepines?. Biol Psychiatry. Dec 1989;26(8):761-5. [Medline].
Gjessing LR, Harding GF, Jenner FA, Johannessen NB. The EEG in three cases of periodic catatonia. Br J Psychiatry. Nov 1967;113(504):1271-82. [Medline].
Glover SG, Escalona R, Bishop J, Saldivia A. Catatonia associated with lorazepam withdrawal. Psychosomatics. Mar-Apr 1997;38(2):148-50. [Medline].
Goldman-Rakic PS. More clues on "latent" schizophrenia point to developmental origins. Am J Psychiatry. Dec 1995;152(12):1701-3. [Medline].
Gonzalez-Seijo JC, Ramos Vicente YM, Lastra Martinez I, Carbonell Masia C. [Treatment of catatonia with lorazepam]. Actas Luso Esp Neurol Psiquiatr Cienc Afines. May-Jun 1993;21(3):90-4. [Medline].
Gothelf D, Hermesh H, Munitz H. [Catatonia--still a common and underdiagnosed syndrome]. Harefuah. Jan 15 1997;132(2):107-13. [Medline].
Greedharry D, Bowen R. Lethal catatonia and neuroleptic malignant syndrome. Can J Psychiatry. Apr 1993;38(3):236-7. [Medline].
Hauser RA, Trehan R. Initial experience with electroconvulsive therapy for progressive supranuclear palsy. Mov Disord. Jul 1994;9(4):467-9. [Medline].
Hayashi H, Aoshima T, Otani K. Malignant catatonia with severe bronchorrhea and its response to electroconvulsive therapy. Prog Neuropsychopharmacol Biol Psychiatry. Mar 2006;30(2):310-1. [Medline].
Heils A, Lesch KP. [Neuroleptic malignant syndrome and acute life-threatening catatonia-- two contrasting disease entities?]. Fortschr Neurol Psychiatr. Jan 1997;65(1):8-15. [Medline].
Heye N, Dunne JW. Malignant catatonia or nonconvulsive status epilepticus?. Mayo Clin Proc. Jan 1995;70(1):101. [Medline].
Hollander E. Medical Psychiatry #24: Autism Spectrum Disorders. New York: Informa Healthcare; 2003.
Hollis C. Child and adolescent (juvenile onset) schizophrenia. A case control study of premorbid developmental impairments. Br J Psychiatry. Apr 1995;166(4):489-95. [Medline].
Hubbard CA, Trugman JM. Reversal of reserpine-induced catalepsy by selective D1 and D2 dopamine agonists. Mov Disord. Oct 1993;8(4):473-8. [Medline].
Hyatt M, Braun N, Briscoe G, Dickson L. The use of midazolam for hypnosedative interviews. Gen Hosp Psychiatry. Jul 1993;15(4):260-2. [Medline].
Jankovic J. Stereotypies. In: Marsden CD, Fahn S, eds. Movement Disorders. Vol 12. Oxford, United Kingdom: Butterworth-Heinemann; 1994:503-517.
Jellinger K. Pallidal, pallidonigral and pallidoluysionigral degenerations including association with thalamic and dentate degenerations. In: Vinken PJ, Bruyn GW, Klawans HL, eds. Handbook of Clinical Neurology Extrapyramidal Disorders. Vol 5. Amsterdam, Netherlands: Elsevier Science; 1986:445-463.
Joseph AB. Catatonia. In: Joseph AB, Young RR, eds. Movement Disorders in Neurology and Neuropsychiatry. Boston, Mass: Blackwell Scientific; 1992:335-342.
Joseph R. Neuropsychiatry, Neuropsychology, and Clinical Neuroscience: Emotion, Evolution, Cognition, Language, Memory, Brain Damage, and Abnormal Behavior. 2nd ed. Baltimore, Md:. Williams and Wilkins,;1996.
Kaufmann RM, Schreinzer D, Strnad A, et al. Case report: intestinal atonia as an unusual symptom of malignant catatonia responsive to electroconvulsive therapy. Schizophr Res. May 2006;84(1):178-9. [Medline].
Keepers GA. Neuroleptic malignant syndrome associated with withdrawal from carbamazepine. Am J Psychiatry. Dec 1990;147(12):1687. [Medline].
Kinrys PF, Logan KM. Periodic catatonia in an adolescent. J Am Acad Child Adolesc Psychiatry. Jul 2001;40(7):741-2. [Medline].
Kirk SA, Kutchins H. The selling of DSM: the rhetoric of science in psychiatry. New York, NY: Aldine de Gruyter; 1992.
Kirubakaran V, Sen S, Wilkinson CB. Catatonic stupor: unusual manifestation of temporal lobe epilepsy. Psychiatr J Univ Ott. Nov 1987;12(4):244-6. [Medline].
Kolvin I, Fundudis T. Elective mute children: psychological development and background factors. J Child Psychol Psychiatry. Jul 1981;22(3):219-32. [Medline].
Komori T, Nomaguchi M, Kodama S, et al. Thyroid hormone and reserpine abolished periods of periodic catatonia: a case report. Acta Psychiatr Scand. Aug 1997;96(2):155-6. [Medline].
Koussa S, Nasnas R. Catatonia and Parkinsonism due to extrapontine myelinolysis following rapid correction of hyponatremia A case report. J Neurol. Jan 2003;250(1):103-5. [Medline].
Kritzinger PR, Jordaan GP. Catatonia: an open prospective series with carbamazepine. Int J Neuropsychopharmacol. Sep 2001;4(3):251-7. [Medline].
Kumar R. Acute severe catatonia in a young woman with chronic schizophrenia responding to parenteral clonazepam. Aust N Z J Psychiatry. Jun 2001;35(3):391. [Medline].
Lance JW, Hickie I, Wakefield D, et al. An akinetic-rigid syndrome, depression, and stereotypies in a young man. Mov Disord. Sep 1998;13(5):835-44. [Medline].
Lauer M, Schirrmeister H, Gerhard A, et al. Disturbed neural circuits in a subtype of chronic catatonic schizophrenia demonstrated by F-18-FDG-PET and F-18-DOPA-PET. J Neural Transm. 2001;108(6):661-70. [Medline].
Laureno R, Karp BP. Cyclosporine mutism. Neurology. Jan 1997;48(1):296-7. [Medline].
Laureys S, Sadzot B, Goldman S, et al. Regional metabolic impairment in vegetative state. A positron emission tomography study with conjunction analysis. J Neurol. 1998;245 (6-7):482.
Lee JW. Catatonia and ECT. Aust N Z J Psychiatry. Dec 1994;28(4):690-1. [Medline].
Lee JW. Catatonic stupor after "ecstasy". BMJ. Mar 12 1994;308(6930):717-8. [Medline].
Lee JW, Schwartz DL. Catatonia associated with hyponatremia. Neuropsychiatry Neuropsychol Behav Neurol. Jan 1997;10(1):63-4. [Medline].
Liddle PF. Commentary on the Modified Rogers Scale and the 'conflict of paradigms' hypothesis. Br J Psychiatry. Mar 1991;158:337-9. [Medline].
Lim J, Yagnik P, Schraeder P, Wheeler S. Ictal catatonia as a manifestation of nonconvulsive status epilepticus. J Neurol Neurosurg Psychiatry. Jul 1986;49(7):833-6. [Medline].
Ljubisavljevic V. Lethal catatonia. Aust N Z J Psychiatry. Aug 2002;36(4):563-4. [Medline].
Looper KJ, Milroy TM. Catatonia 20 years later. Am J Psychiatry. Jun 1997;154(6):883. [Medline].
Louis ED, Pflaster NL. Catatonia mimicking nonconvulsive status epilepticus. Epilepsia. Sep 1995;36(9):943-5. [Medline].
Lund CE, Mortimer AM, Rogers D. Motor, volitional and behavioural disorders in schizophrenia. 1: Assessment using the Modified Rogers Scale. Br J Psychiatry. Mar 1991;158:323-7, 333-6. [Medline].
MacQueen GM, Rosebush PI, Mazurek MF. Neuropsychiatric aspects of the adult variant of Tay-Sachs disease. J Neuropsychiatry Clin Neurosci. Winter 1998;10(1):10-9. [Medline].
Mahendra B. Where have all the catatonics gone?. Psychol Med. Nov 1981;11(4):669-71. [Medline].
Mahmood T. Bromocriptine in catatonic stupor. Br J Psychiatry. Mar 1991;158:437-8. [Medline].
Mann SC, Auriacombe M, Macfadden W, et al. [Lethal catatonia: clinical aspects and therapeutic intervention. A review of the literature]. Encephale. May-Jun 2001;27(3):213-6. [Medline].
Mark VW. Arm levitation in progressive supranuclear palsy. Neurology. Feb 8 2000;54(3):774; discussion 774-5. [Medline].
Masi G, Mucci M, Floriani C. Acute catatonia after a single dose of ecstasy. J Am Acad Child Adolesc Psychiatry. Aug 2002;41(8):892. [Medline].
Masiar SJ. Failure to use ECT in treatment of catatonia. Am J Psychiatry. Jan 1992;149(1):144-5. [Medline].
Mastain B, Rascle C, Thomas P, Goudemand M. Zolpidem in catatonic syndrome: from a pharmacological test to a physiophathological hypothesis. Mov Disord. 1998;13(suppl 2):46.
Mastain B, Vaiva G, Guerouaou D, et al. [Favourable effect of zolpidem on catatonia]. Rev Neurol (Paris). Jan 1995;151(1):52-6. [Medline].
McCall WV. The response to an amobarbital interview as a predictor of therapeutic outcome in patients with catatonic mutism. Convuls Ther. 1992;8(3):174-178.
McCall WV, Mann SC, Shelp FE, Caroff SN. Fatal pulmonary embolism in the catatonic syndrome: two case reports and a literature review. J Clin Psychiatry. Jan 1995;56(1):21-5. [Medline].
McCall WV, Shelp FE, McDonald WM. Controlled investigation of the amobarbital interview for catatonic mutism. Am J Psychiatry. Feb 1992;149(2):202-6. [Medline].
McKenna PJ, Lund CE, Mortimer AM, Biggins CA. Motor, volitional and behavioural disorders in schizophrenia. 2: The 'conflict of paradigms' hypothesis. Br J Psychiatry. Mar 1991;158:328-36. [Medline].
Menza MA. Lorazepam and catatonia. J Clin Psychiatry. Apr 1991;52(4):186-8. [Medline].
Miyaoka H, Shishikura K, Otsubo T, et al. Diazepam-responsive neuroleptic malignant syndrome: a diagnostic subtype?. Am J Psychiatry. Jun 1997;154(6):882. [Medline].
Morrison JR. Catatonia. Retarded and excited types. Arch Gen Psychiatry. Jan 1973;28(1):39-41. [Medline].
Muller U, Klimke A, Janner M, Gaebel W. [Electroconvulsive therapy in psychiatric clinics in Germany in 1995]. Nervenarzt. Jan 1998;69(1):15-26. [Medline].
Muqit MM, Rakshi JS, Shakir RA, Larner AJ. Catatonia or abulia? A difficult differential diagnosis. Mov Disord. Mar 2001;16(2):360-2. [Medline].
Neuman E, Rancurel G, Lecrubier Y, et al. Schizophreniform catatonia on 6 cases secondary to hydrocephalus with subthalamic mesencephalic tumor associated with hypodopaminergia. Neuropsychobiology. 1996;34(2):76-81. [Medline].
Neumarker KJ. Classification matters for catatonia and autism in children. Int Rev Neurobiol. 2006;72:3-19. [Medline].
Northoff G, Eckert J, Fritze J. Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine. J Neurol Neurosurg Psychiatry. Apr 1997;62(4):404-6. [Medline].
O'Connell K, Ramchandani D. On "Catatonia on the consultation-liaison service". Psychosomatics. Mar-Apr 1993;34(2):191. [Medline].
Ohta M, Kano Y, Nagai Y. Catatonia in individuals with autism spectrum disorders in adolescence and early adulthood: a long-term prospective study. Int Rev Neurobiol. 2006;72:41-54. [Medline].
Osman AA, Khurasani MH. Lethal catatonia and neuroleptic malignant syndrome. A dopamine receptor shut-down hypothesis. Br J Psychiatry. Oct 1994;165(4):548-50. [Medline].
Ossemann M, Sindic CJ, Laterre C. Tetrabenazine as a cause of neuroleptic malignant syndrome. Mov Disord. Jan 1996;11(1):95. [Medline].
Panikkar GP, Mayerhoff D. Catatonic syndrome in an adolescent male immigrant: a case report. CNS Spectrums. 1997;2(2):33-36.
Pataki J, Zervas IM, Jandorff L. Catatonia in a university inpatient service (1985-1990). Convuls Ther. 1992;8:163-173.
Petracca G, Migliorelli R, Vázquez S, Starkstein SE. SPECT findings before and after ECT in a patient with major depression and Cotard's syndrome. J Neuropsychiatry Clin Neurosci. Fall 1995;7(4):505-7. [Medline].
Petzinger GM, Bressman SB. A case of tetrabenazine-induced neuroleptic malignant syndrome after prolonged treatment. Mov Disord. Mar 1997;12(2):246-8. [Medline].
Pfister HW, Preac-Mursic V, Wilske B, et al. Catatonic syndrome in acute severe encephalitis due to Borrelia burgdorferi infection. Neurology. Feb 1993;43(2):433-5. [Medline].
Pichot P. Catatonia: a separate category in DSM-IV?. Integrative Psychiatry. 1991;7:6-7.
Plum F, Posner JB. The diagnosis of stupor and coma. In: Contemporary Neurology. Vol 19. Philadelphia, Pa: FA Davis Co; 1980.
Popkin MK, Tucker GJ. "Secondary" and drug-induced mood, anxiety, psychotic, catatonic, and personality disorders: a review of the literature. J Neuropsychiatry Clin Neurosci. Fall 1992;4(4):369-85. [Medline].
Primavera A, Fonti A, Novello P, et al. Epileptic seizures in patients with acute catatonic syndrome. J Neurol Neurosurg Psychiatry. Nov 1994;57(11):1419-22. [Medline].
Raitiere MN. Subcortical dysrhythmia and catatonia. Biol Psychiatry. Nov 1986;21(13):1351-2. [Medline].
Raja M, Altavista MC, Cavallari S, Lubich L. Neuroleptic malignant syndrome and catatonia. A report of three cases. Eur Arch Psychiatry Clin Neurosci. 1994;243(6):299-303. [Medline].
Realmuto GM, August GJ. Catatonia in autistic disorder: a sign of comorbidity or variable expression?. J Autism Dev Dis. 1997;21:517-528.
Reeves RR, Torres RA, Liberto V, Hart RH. Atypical neuroleptic malignant syndrome associated with olanzapine. Pharmacotherapy. May 2002;22(5):641-4. [Medline].
Rey JM, Walter G. Half a century of ECT use in young people. Am J Psychiatry. May 1997;154(5):595-602. [Medline].
Riggins SA, Sindt R, Challakere K, Armon C. A case of the dyskinetic form of neuroleptic malignant syndrome without muscle rigidity. Mov Disord. 1998;13(suppl 2):210.
Roca B, Saez-Royuela A, Vilar C, et al. [Lethal catatonia: a case report]. An Med Interna. May 1997;14(5):266-7. [Medline].
Rohland BM, Carroll BT, Jacoby RG. ECT in the treatment of the catatonic syndrome. J Affect Disord. Dec 1993;29(4):255-61. [Medline].
Rosebush PI, Hildebrand AM, Furlong BG, Mazurek MF. Catatonic syndrome in a general psychiatric inpatient population: frequency, clinical presentation, and response to lorazepam. J Clin Psychiatry. Sep 1990;51(9):357-62. [Medline].
Rosebush PI, Hildebrand AM, Mazurek MF. The treatment of catatonia: benzodiazepines of ECT?. Am J Psychiatry. Sep 1992;149(9):1279-80. [Medline].
Rosebush PI, MacQueen GM, Clarke JT, et al. Late-onset Tay-Sachs disease presenting as catatonic schizophrenia: diagnostic and treatment issues. J Clin Psychiatry. Aug 1995;56(8):347-53. [Medline].
Rosebush PI, Mazurek MF. Catatonia: re-awakening to a forgotten disorder. Mov Disord. May 1999;14(3):395-7. [Medline].
Rosebush PI, Mazurek MF. Relationship between primary depression and responsiveness to lorazepam in patients presenting to a psychiatry service with catatonia. Ann Neurol. 1994;36:279-280.
Rosebush PI, Mazurek MF. The treatment of catatonic syndrome with lorazepam. Mov Disord. 1992;7 (suppl 1):165.
Rosenfeld MJ, Friedman JH. Catatonia responsive to lorazepam: a case report. Mov Disord. Jan 1999;14(1):161-2. [Medline].
Rudorfer MV, Manji HK, Potter WZ. Bupropion, ECT, and dopaminergic overdrive. Am J Psychiatry. Aug 1991;148(8):1101-2. [Medline].
Rudorfer MV, Manji HK, Potter WZ. ECT and delirium in Parkinson's disease. Am J Psychiatry. Dec 1992;149(12):1758-9; author reply 1759-60. [Medline].
Rummans TA. Malignant catatonia or nonconvulsive status epilepticus?. Mayo Clin Proc. 1995;70:101.
Sackeim HA, Long J, Luber B, et al. Physical properties and quantification of the ECT stimulus: I. Basic principles. Convuls Ther. Jun 1994;10(2):93-123. [Medline].
Saposnik G, Bueri JA, Rey RC. Catalepsy after stroke. Neurology. Sep 22 1999;53(5):1132-5. [Medline].
Saposnik G, Bueri JA, Rey RC, Sica RE. Catalepsy after acute stroke. Mov Disord. 1998;13(suppl 2):75.
Saver JL, Greenstein P, Ronthal M, Mesulam MM. Asymmetric catalepsy after right hemisphere stroke. Mov Disord. 1993;8(1):69-73. [Medline].
Sevlever G, Taratuto AH, de las Carreras MC, Leiguarda R, Nogués M. Catatonia secondary to acute Chagas' encephalitis. J Neurol Neurosurg Psychiatry. Sep 1987;50(9):1244. [Medline].
Silva H, Jerez S, Catenacci M, Mascaro J. [Decrease of catatonic schizophrenia in patients hospitalized in 1984 in comparison to 1964]. Acta Psiquiatr Psicol Am Lat. Jul-Dec 1989;35(3-4):132-8. [Medline].
Silva RR, Munoz DM, Alpert M, et al. Neuroleptic malignant syndrome in children and adolescents. J Am Acad Child Adolesc Psychiatry. Feb 1999;38(2):187-94. [Medline].
Smith JK. Dentatorubropallidoluysian atrophy. In: Vinken PJ, Bruyn GW, eds. Handbook of Clinical Neurology. System Disorders and Atrophies. Vol 21. Amsterdam, Netherlands: North-Holland Publishing Co; 1975:519-534.
Spitzer RL. Catatonia: a separate category in DSM-IV?. Integrative Psychiatry. 1991;7:7-9.
Starkstein SE, Petracca G, Teson A, et al. Catatonia in depression: prevalence, clinical correlates, and validation of a scale. J Neurol Neurosurg Psychiatry. Mar 1996;60(3):326-32. [Medline].
Stemp LI. Management of lethal catatonia with dantrolene sodium. Crit Care Med. Sep 1993;21(9):1403. [Medline].
Stompe T, Ortwein-Swoboda G, Ritter K, et al. Are we witnessing the disappearance of catatonic schizophrenia?. Compr Psychiatry. May-Jun 2002;43(3):167-74. [Medline].
Strub RL. Mental disorders in brain disease. In: Frederiks JA, ed. Handbook of Clinical Neurology, Neurobehavioral Disorders. Vol 2. Amsterdam, Netherlands: Elsevier Science; 1985:413-441.
Swartz CM. Catatonia and not neuroleptic malignant syndrome. Br J Psychiatry. Feb 1993;162:274-5. [Medline].
Taylor MA. Catatonia: a review of a behavioral neurologic syndrome. Neuropsychiatry Neuropsychol Behav Neurol. 1990;3(1):48-77.
Taylor MA, Abrams R. Catatonia. Prevalence and importance in the manic phase of manic-depressive illness. Arch Gen Psychiatry. Oct 1977;34(10):1223-5. [Medline].
Theoharides TC. Reply to letter to the editors by Carroll and Taylor. J Clin Psychopharmacol. 1997;27:237-238.
Tinuper P, Montagna P, Plazzi G, Lugaresi E. Transient unresponsiveness in the elderly: possible episodes of idiopathic recurring stupor. Arch Neurol. Mar 1995;52(3):232. [Medline].
Tsai JH, Yang P, Yen JY, et al. Zotepine-induced catatonia as a precursor in the progression to neuroleptic malignant syndrome. Pharmacotherapy. Aug 2005;25(8):1156-9. [Medline].
Ungvari GS, Leung CM, Chiu HM. Lorazepam in stupor. Br J Clin Pract. May-Jun 1994;48(3):165-6. [Medline].
Ungvari GS, Leung CM, Wong MK, Lau J. Benzodiazepines in the treatment of catatonic syndrome. Acta Psychiatr Scand. Apr 1994;89(4):285-8. [Medline].
Ungvari GS, Leung HC, Lee TS. Benzodiazepines and the psychopathology of catatonia. Pharmacopsychiatry. Nov 1994;27(6):242-5. [Medline].
Ungvari GS, Rankin JA. Speech-prompt catatonia: a case report and review of the literature. Compr Psychiatry. Jan-Feb 1990;31(1):56-61. [Medline].
Unni KE, Shivakumar V, Dutta TK, Chandrasekaran R. Fever of unknown cause presenting as Catatonia. J Assoc Physicians India. Feb 1995;43(2):134-5. [Medline].
Valldeoriola F, Graus F, Rimola A, et al. Cyclosporine-associated mutism in liver transplant patients. Neurology. Jan 1996;46(1):252-4. [Medline].
Van de Kelft E, De Hert M, Heytens L, et al. Management of lethal catatonia with dantrolene sodium. Crit Care Med. Nov 1991;19(11):1449-51. [Medline].
van Dongen HR, Catsman-Berrevoets CE, van Mourik M. The syndrome of 'cerebellar' mutism and subsequent dysarthria. Neurology. Nov 1994;44(11):2040-6. [Medline].
Van Sweden B, Crevits L. Idiopathic recurring stupor. Neurology. Oct 1995;45(10):1947. [Medline].
Volkow ND, Harper A, Munnisteri D, Clother J. AIDS and catatonia. J Neurol Neurosurg Psychiatry. Jan 1987;50(1):104. [Medline].
Walls MJ, Bowers TC, Dilsaver SC, Swann AC. Catatonia associated with depression secondary to complex partial epilepsy. J Clin Psychiatry. Feb 1993;54(2):73. [Medline].
Walshe JM. Wilson's disease. In: Vinken PJ, Bruyn GW, Klawans HL, eds. Handbook of Clinical Neurology. Vol 5. Amsterdam, Netherlands: Elsevier Science; 1986:223-238.
Weller M, Kornhuber J. A rationale for NMDA receptor antagonist therapy of the neuroleptic malignant syndrome. Med Hypotheses. Aug 1992;38(4):329-33. [Medline].
Weller M, Kornhuber J. Clozapine and neuroleptic malignant syndrome: a never-ending story. J Clin Psychopharmacol. Jun 1997;17(3):233-4. [Medline].
Wheeler AH, Ziegler MG, Insel PA, Motulsky HJ. Episodic catatonia, hypertension, and tachycardia: elevated plasma catecholamines. Neurology. Jul 1985;35(7):1053-5. [Medline].
White DA, Robins AH. Catatonia: harbinger of the neuroleptic malignant syndrome. Br J Psychiatry. Mar 1991;158:419-21. [Medline].
Wilcox JA. Structural brain abnormalities in catatonia. Neuropsychobiology. 1993;27(2):61-4. [Medline].
Wilcox JA, Nasrallah HA. Organic factors in catatonia. Br J Psychiatry. Dec 1986;149:782-4. [Medline].
Wolanczyk T, Komender J, Brzozowska A. Catatonic syndrome preceded by symptoms of anorexia nervosa in a 14- year-old boy with arachnoid cyst. Eur Child Adolesc Psychiatry. Sep 1997;6(3):166-9. [Medline].
Woodbury MM, Woodbury MA. Neuroleptic-induced catatonia as a stage in the progression toward neuroleptic malignant syndrome. J Am Acad Child Adolesc Psychiatry. Nov 1992;31(6):1161-4. [Medline].
Zervas IM, Fink M. ECT and delirium in Parkinson's disease. Am J Psychiatry. Dec 1992;149(12):1758; discussion 1759-60. [Medline].
Further Reading
Keywords
catatonia, unresponsiveness, deficits in fetal cortical development, dopaminergic blockade, glutamatergic dysfunction, dysfunction in neurotransmission of noradrenaline, dysfunction in neurotransmission of serotonin, frontal anomalies, motoric immobility, excessive motor activity, extreme negativism, mutism, peculiarities of voluntary movement, echolalia, echopraxia, stupor, oppositionism, posturing, catalepsy, automatic obedience, echophenomena, rigidity, verbigeration, withdrawal, akinesia, stupor
