Diagnostic Considerations

In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

Acute stress disorder
Anti-NMDA receptor encephalitis
Astrocytoma
Autistic disorder^[5]
Brief reactive psychosis with catatonia
Carotid disease
Cephalosporin-associated neurotoxicity^[69]
Cocaine-induced leukoencephalopathy^[70]
Conversion disorder^{[71, 72]}
Delirium
Dystonia
Encephalopathy - HIV infection
Extrapontine myelinolysis
Fabry disease
Hallervorden-Spatz disease
Huntington disease
Inherited metabolic disorders
Inherited neurometabolic disorders
Latah betul^{[41, 42, 43]}
Locked-in syndrome
Low-grade astrocytoma
Major depression, single episode with catatonic features
Malignant hyperthermia
Manganese neurotoxicity^[73]
Medication adverse effect - Levetiracetam, zotepine
Mega cisterna magna^[74]
Meningioma
Mood disorders
Neuroleptic malignant syndrome (NMS)
Neurosarcoidosis
Neurosyphilis
Pantothenate kinase-associated neurodegeneration (PKAN), also known as neurodegeneration with brain iron accumulation 1 (NBIA1), also called Hallervorden-Spatz syndrome
Parkinson disease
Parkinson-plus syndromes
Posttraumatic stress disorder
Posterior reversible encephalopathy syndrome^[75]
Prion disease^[36]
Progressive multifocal leukoencephalopathy
Progressive supranuclear palsy
Renal failure^[69]
Schizophrenia
Serotonin syndrome^[76]- the serotonin syndrome checklist^[77]is a simple tool to assess a patient for evidence of serotonin syndrome
Stiff-person syndrome
Stupor
Subdural hematoma
Substance intoxication - Cyclosporine, phencyclidine
Syphilis
Systemic lupus erythematosus^[78]
Tay-Sachs disease
Thermal injury
Torticollis
Transplantation of kidney and liver^[79]
Tuberculosis
Vegetative states
Von Economo encephalitis
Zaghrouta^{[71, 72]}
Zolpidem withdrawal^[80]

Differential Diagnoses

Workup

Fink M and Taylor MA. The catatonia syndrome: forgotten but not gone. Arch Gen Psychiatry. 2009. 66:1173.
Freudenreich O, Nejad SH, Francis A, Fricchione GL. Psychosis, mania, and catatonia. Levenson JL. Textbook of Psychosomatic Medicine: Psychiatric Care of the Medically Ill. 2nd ed. Washington DC: American Psychiatric Publishing; 2011.
Freudenreich O, Nejad SH, Francis A, Fricchione GL. Phenomenology of schizophrenia. Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
Pesyna C, Benson L, Lacy M, Cooper J. Excited Catatonia With a Normal Video EEG: a Case of Anti-NMDA Receptor Encephalitis. J Neuropsychiatry Clin Neurosci. 2014. 26:2:
Brasic JR, Barnett JY, Will MV, Nadrich RH, Sheitman BB, Ahmad R, et al. Dyskinesias differentiate autistic disorder from catatonia. CNS Spectr. 2000 Dec. 5(12):19-22. [QxMD MEDLINE Link].
Ungvari GS, Caroff SN, Gerevich J. The Catatonia Conundrum: Evidence of Psychomotor Phenomena as a Symptom Dimension in Psychotic Disorders. Schizophr Bull. 2009 Sep 23. [QxMD MEDLINE Link]. [Full Text].
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. 2009 Feb 1. 33(1):81-5. [QxMD MEDLINE Link].
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
Brasic J and Morgan RH. Conversion disorder in childhood. German Journal of Psychiatry. 2002. 5:54-61.
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. 1999 Feb. 84(1):239-46. [QxMD MEDLINE Link].
Brasic JR. A 20-Year-Old Man Who Stopped Speaking. Medscape. Available at https://reference.medscape.com/viewarticle/883207_6. July 31, 2017; Accessed: March 1, 2018.
Brasic J, Barnett J, and Zagzag D. Twenty-four-year unremitting course of facial tics in progressive catatonia complicating autism spectrum disorder. Scullin M. 1st World Congress on Tourette Syndrome and Tic Disorders. London: Frontiers Media SA; 2015.
Lafargue T, Brasic J. Neurodevelopmental hypothesis of schizophrenia: a central sensory disturbance. Med Hypotheses. 2000 Oct. 55(4):314-8. [QxMD MEDLINE Link].
Zervas IM, Theleritis C, Soldatos CR. Using ECT in schizophrenia: A review from a clinical perspective. World J Biol Psychiatry. 2011 Apr 12. [QxMD MEDLINE Link].
Lee JW. Neuroleptic-induced catatonia: clinical presentation, response to benzodiazepines, and relationship to neuroleptic malignant syndrome. J Clin Psychopharmacol. 2010 Feb. 30 (1):3-10. [QxMD MEDLINE Link].
Kannabiran M, McCarthy J. The mental health needs of people with autism spectrum disorders. Psychiatry. 2009 Oct. 8(10):398-401.
Gaind GS, Rosebush PI, Mazurek MF. Lorazepam treatment of acute and chronic catatonia in two mentally retarded brothers. J Clin Psychiatry. 1994 Jan. 55(1):20-3. [QxMD MEDLINE Link].
Hare DJ, Malone C. Catatonia and autistic spectrum disorders. Autism. 2004 Jun. 8(2):183-95. [QxMD MEDLINE Link].
Baguley IJ. The excitatory:inhibitory ratio model (EIR model): An integrative explanation of acute autonomic overactivity syndromes. Med Hypotheses. 2008. 70(1):26-35. [QxMD MEDLINE Link].
Rasmussen SA, Mazurek MF, Rosebush PI. Catatonia: Our current understanding of its diagnosis, treatment and pathophysiology. World J Psychiatry. 2016 Dec 22. 6 (4):391-398. [QxMD MEDLINE Link].
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. 2001 Feb 15. 119(1):71-6. [QxMD MEDLINE Link].
Kahlbaum KL. Catatonia. Baltimore, Md: Johns Hopkins University Press; 1874/1973.
Stöber G, Seelow D, Rüschendorf F, Ekici A, Beckmann H, Reis A. Periodic catatonia: confirmation of linkage to chromosome 15 and further evidence for genetic heterogeneity. Hum Genet. 2002 Oct. 111 (4-5):323-30. [QxMD MEDLINE Link].
Meyer J, Huberth A, Ortega G, Syagailo YV, Jatzke S, Mössner R, et al. A missense mutation in a novel gene encoding a putative cation channel is associated with catatonic schizophrenia in a large pedigree. Mol Psychiatry. 2001 May. 6 (3):302-6. [QxMD MEDLINE Link].
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.
Lee J, Teoh T, Lee TS. Catatonia and psychosis associated with sibutramine: a case report and pathophysiologic correlation. J Psychosom Res. 2008 Jan. 64(1):107-9. [QxMD MEDLINE Link].
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. 2009 Jul. 18(7):458-63. [QxMD MEDLINE Link].
Wachtel LE, Griffin M, Reti IM. Electroconvulsive Therapy in a Man With Autism Experiencing Severe Depression, Catatonia, and Self-Injury. J ECT. 2009 May 27. [QxMD MEDLINE Link].
Dhossche DM, Reti IM, Wachtel LE. Catatonia and autism: a historical review, with implications for electroconvulsive therapy. J ECT. 2009 Mar. 25(1):19-22. [QxMD MEDLINE Link].
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. 2008 Sep. 17(6):327-35. [QxMD MEDLINE Link].
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. 2009 Mar. 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. 2009 Oct. 16(10):1328, 1386. [QxMD MEDLINE Link].
Blanc F, Berna F, Fleury M, Lita L, Ruppert E, Ferriby D, et al. [Inaugural psychotic events in multiple sclerosis?]. Rev Neurol (Paris). 2009 Sep 5. [QxMD MEDLINE Link].
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.
Nielsen N, Nielsen NB. [Malignant neuroleptic syndrome in a 15-year old girl after a single injection of a high-dose neuroleptic]. Ugeskr Laeger. 1991 Aug 5. 153(32):2239-40. [QxMD MEDLINE Link].
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. 2001 May. 16(3):526-9. [QxMD MEDLINE Link].
Francis A, Fink M, Appiani F, Bertelsen A, Bolwig TG, et al. Catatonia in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. J ECT. 2010 Dec. 26 (4):246-7. [QxMD MEDLINE Link].
Zisselman MH, Jaffe RL. ECT in the treatment of a patient with catatonia: consent and complications. Am J Psychiatry. 2010 Feb. 167 (2):127-32. [QxMD MEDLINE Link].
van der Heijden FM, Tuinier S, Arts NJ, Hoogendoorn ML, Kahn RS, Verhoeven WM. Catatonia: disappeared or under-diagnosed?. Psychopathology. 2005 Jan-Feb. 38 (1):3-8. [QxMD MEDLINE Link].
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. 2000 Dec. 49(6):423-9. [QxMD MEDLINE Link].
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. 2005 Nov. 35(11):1667-75. [QxMD MEDLINE Link].
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. 1997 Jan-Feb. 38(1):61-7. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Johnson J. Catatonia: the tension insanity. Br J Psychiatry. 1993 Jun. 162:733-8. [QxMD MEDLINE Link].
Rogers D. Catatonia: a contemporary approach. J Neuropsychiatry Clin Neurosci. 1991 Summer. 3(3):334-40. [QxMD MEDLINE Link].
Guggenheim FG, Babigian HM. Catatonic schizophrenia: epidemiology and clinical course. A 7-year register study of 798 cases. J Nerv Ment Dis. 1974 Apr. 158(4):291-305. [QxMD MEDLINE Link].
Abrams R, Taylor MA. Catatonia. A prospective clinical study. Arch Gen Psychiatry. 1976 May. 33(5):579-81. [QxMD MEDLINE Link].
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. 2005 Jan. 29(1):27-38. [QxMD MEDLINE Link].
Carroll BT. Kahlbaum's catatonia revisited. Psychiatry Clin Neurosci. 2001 Oct. 55(5):431-6. [QxMD MEDLINE Link].
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. 2008 Apr 15. 158(3):356-62. [QxMD MEDLINE Link].
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. 2009 Sep. 113(2-3):233-40. [QxMD MEDLINE Link].
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. 2009 Jun 30. 168(1):78-85. [QxMD MEDLINE Link].
Krishna KR, Maniar RC, Harbishettar VS. A comparative study of "idiopathic catatonia’’ with catatonia in schizophrenia. Asian J Psych. 2011. 4:129-33.
Fischel T, Krivoy A, Brenner I, Weizman A. Priapism as an unusual manifestation of catatonia: a case report. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Apr 30. 33(3):570. [QxMD MEDLINE Link].
Chouinard MJ, Nguyen DK, Clement JF, Bruneau MA. Catatonia induced by levetiracetam. Epilepsy Behav. 2006 Feb. 8(1):303-7. [QxMD MEDLINE Link].
Youssef NA, Benazzi F, Desan PH. Levofloxacin-induced catatonia. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Jun 15. 33(4):741-2. [QxMD MEDLINE Link].
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. 2009 Nov. 3 (4):237-239.
Rizos DV, Peritogiannis V, Gkogkos C. Catatonia in the intensive care unit. Gen Hosp Psychiatry. 2011 Jan-Feb. 33(1):e1-2. [QxMD MEDLINE Link].
Francis A. Catatonia: diagnosis, classification, and treatment. Curr Psychiatry Rep. 2010 Jun. 12 (3):180-5. [QxMD MEDLINE Link].
Denysenko L, Nicolson SE. Cefoxitin and ciprofloxacin neurotoxicity and catatonia in a patient on hemodialysis. Psychosomatics. 2011 Jul-Aug. 52(4):379-83. [QxMD MEDLINE Link].
Anbarasan D, Campion P, Howard J. Drug-induced leukoencephalopathy presenting as catatonia. Gen Hosp Psychiatry. 2011 Jan-Feb. 33(1):85.e1-3. [QxMD MEDLINE Link].
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. 2008 Apr. 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. 2003 Oct. 96(Suppl10):S35.
Jain S, Ferrando SJ. Manganese neurotoxicity presenting with depression, psychosis and catatonia. Psychosomatics. 2011 Jan-Feb. 52(1):74-7. [QxMD MEDLINE Link].
Kumar S, Sur S, Singh A. Mega cisterna magna associated with recurrent catatonia: a case report. Biol Psychiatry. 2011 Aug 15. 70(4):e19. [QxMD MEDLINE Link].
Spiegel DR, Varnell C Jr. A case of catatonia due to posterior reversible encephalopathy syndrome treated successfully with antihypertensives and adjunctive olanzapine. Gen Hosp Psychiatry. 2011 May-Jun. 33(3):302.e3-5. [QxMD MEDLINE Link].
Keck PE and Arnold LM. The serotonin syndrome. Psychiatr Ann. 2000. 30:333–43.
Brasic JR, Barnett JY, Kaplan D, Sheitman BB, Aisemberg P, Lafargue RT, et al. Clomipramine ameliorates adventitious movements and compulsions in prepubertal boys with autistic disorder and severe mental retardation. Neurology. 1994 Jul. 44 (7):1309-12. [QxMD MEDLINE Link].
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. 2009 Jan-Feb. 31(1):90-2. [QxMD MEDLINE Link].
Kalivas KK, Bourgeois JA. Catatonia after liver and kidney transplantation. Gen Hosp Psychiatry. 2009 Mar-Apr. 31(2):196-8. [QxMD MEDLINE Link].
Hsieh MH, Chen TC, Chiu NY, Chang CC. Zolpidem-related withdrawal catatonia: a case report. Psychosomatics. 2011 Sep-Oct. 52(5):475-7. [QxMD MEDLINE Link].
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. 2008 Mar 7. [QxMD MEDLINE Link].
England ML, Ongür D, Konopaske GT, Karmacharya R. Catatonia in psychotic patients: clinical features and treatment response. J Neuropsychiatry Clin Neurosci. 2011 Spring. 23 (2):223-6. [QxMD MEDLINE Link].
Daniels J. Catatonia: clinical aspects and neurobiological correlates. J Neuropsychiatry Clin Neurosci. 2009 Fall. 21 (4):371-80. [QxMD MEDLINE Link].
Sienaert P, Rooseleer J, De Fruyt J. Measuring catatonia: a systematic review of rating scales. J Affect Disord. 2011 Dec. 135(1-3):1-9. [QxMD MEDLINE Link].
Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand. 1996 Feb. 93(2):129-36. [QxMD MEDLINE Link].
Larsen HH, Ritchie JC, McNutt MD, Musselman DL. Pulmonary embolism in a patient with catatonia: an old disease, changing times. Psychosomatics. 2011 Jul-Aug. 52(4):387-91. [QxMD MEDLINE Link].
Gjessing LR, Harding GF, Jenner FA, Johannessen NB. The EEG in three cases of periodic catatonia. Br J Psychiatry. 1967 Nov. 113 (504):1271-82. [QxMD MEDLINE Link].
Gjessing LR, Harding GF, Jenner FA, Johannessen NB. The EEG in three of Gjessing's patients with periodic catatonia. Electroencephalogr Clin Neurophysiol. 1967 Nov. 23 (5):490. [QxMD MEDLINE Link].
England ML, Ongür D, Konopaske GT, Karmacharya R. Catatonia in psychotic patients: clinical features and treatment response. J Neuropsychiatry Clin Neurosci. 2011 Spring. 23(2):223-6. [QxMD MEDLINE Link].
Peralta V, Campos MS, de Jalon EG, Cuesta MJ. DSM-IV catatonia signs and criteria in first-episode, drug-naive, psychotic patients: psychometric validity and response to antipsychotic medication. Schizophr Res. 2010 May. 118(1-3):168-75. [QxMD MEDLINE Link].
Van Den Eede F, Van Hecke J, Van Dalfsen A, Van den Bossche B, Cosyns P, Sabbe BG. The use of atypical antipsychotics in the treatment of catatonia. Eur Psychiatry. 2005 Aug. 20(5-6):422-9. [QxMD MEDLINE Link].
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. 2009 Nov 13. 33(8):1559-60. [QxMD MEDLINE Link].
Huang YC, Lin CC, Hung YY, Huang TL. Rapid relief of catatonia in mood disorder by lorazepam and diazepam. Biomed J. 2013 Jan-Feb. 36(1):35-9. [QxMD MEDLINE Link].
Lin CC, Huang TL. Lorazepam-diazepam protocol for catatonia in schizophrenia: A 21-case analysis. Compr Psychiatry. 2013 Jul 12. [QxMD MEDLINE Link].
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. 2009 Dec. 94(2):219-26. [QxMD MEDLINE Link].
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.
Huang TL, Hung YY. Lorazepam reduces the serum brain-derived neurotrophic factor level in schizophrenia patients with catatonia. Prog Neuropsychopharmacol Biol Psychiatry. 2009 Feb 1. 33(1):158-9. [QxMD MEDLINE Link].
Grover S, Aggarwal M. Long-term maintenance lorazepam for catatonia: a case report. Gen Hosp Psychiatry. 2011 Jan-Feb. 33(1):82.e1-3. [QxMD MEDLINE Link].
Chanpattana W, Kramer BA, Kunigiri G, Gangadhar BN, Kitphati R, Andrade C. A Survey of the Practice of Electroconvulsive Therapy in Asia. J ECT. 2009 May 13. [QxMD MEDLINE Link].
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. 2008 Mar. 165(3):329-33. [QxMD MEDLINE Link].
Moss L, Vaidya N. Does Comorbid Alcohol and Substance Abuse Affect Electroconvulsive Therapy Outcome in the Treatment of Mood Disorders?. J ECT. 2013 Jul 15. [QxMD MEDLINE Link].
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. 2009 Apr. 18(4):250-4. [QxMD MEDLINE Link].
Slooter AJ, Braun KP, Balk FJ, et al. Electroconvulsive therapy for malignant catatonia in childhood. Pediatr Neurol. 2005 Mar. 32(3):190-2. [QxMD MEDLINE Link].
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.
Nomoto H, Hatta K, Usui C, Ito M, Kita Y, Arai H. Vitamin K deficiency due to prolongation of antibiotic treatment and decrease in food intake in a catatonia patient. Psychosomatics. 2011 Sep-Oct. 52(5):486-7. [QxMD MEDLINE Link].
Beach SR, Gomez-Bernal F, Huffman JC, Fricchione GL. Alternative treatment strategies for catatonia: A systematic review. Gen Hosp Psychiatry. 2017 Sep. 48:1-19. [QxMD MEDLINE Link].

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Serotonin syndrome checklist.

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Table. Causes of Catatonia by Category

Table. Causes of Catatonia by Category

Category	Causes
Neurologic conditions	Neuroleptic malignant syndrome^[27] Administration of agents that block postsynaptic dopamine receptors* Administration of sibutramine^[28](withdrawn from US market October 8, 2010) Withdrawal of lorazepam and other sedatives Akinetic-rigid syndrome Anti-NMDA receptor encephalitis^[4] Arachnoid cyst in right parietal region Astrocytoma Atrophy of left amygdala^[29] Autistic disorder^{[17, 10, 11, 30, 31, 32, 33, 34, 35, 12, 13]} 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 (herpesvirus, Trypanosoma cruzi) Encephalopathy (Borrelia burgdorferi, HIV infection, Wernicke encephalopathy) Familial fatal insomnia^[36] 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^{[37, 38]} Neurosyphilis Nonconvulsive status epilepticus Pervasive developmental disorders^{[10, 11, 34]} Pallidoluysian atrophy Paraneoplastic encephalitis^[39] 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 (lethargic) encephalitis Wilson disease
Psychiatric conditions	Acute stress disorder Anorexia nervosa Autistic disorder^[17] Brief reactive psychosis with catatonia Conversion disorder Hysteria Major depression, single episode with catatonic features Mood disorders Neuroleptic malignant syndrome^[27] Posttraumatic stress disorder Schizophrenia Substance intoxication (3,4-methylenedioxymethamphetamine [“ecstasy”], alcohol, amphetamine, phencyclidine, substance withdrawal, hypnotic-sedative, lorazepam)
Psychological factors	Immigration Experiencing rejection of an expression of love Feelings of alienation in an unfamiliar country
Medical conditions	AIDS Acute intermittent porphyria Addison disease Bacterial septicemia Bronchorrhea Carcinoid tumors Diabetic ketoacidosis Encephalopathy (hepatic, HIV infection, Wernicke encephalopathy) Fever of unknown cause Heat stroke Hepatic failure Hereditary coproporphyria Homocystinuria Hypercalcemia Hyperparathyroidism Hyperthyroidism Hyponatremia Hypothermia Intestinal atony Malaria Neuroleptic malignant syndrome^[27] 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 (lethargic) encephalitis
Obstetric conditions	Hypopituitarism secondary to postpartum hemorrhage
*Administration of agents that block postsynaptic dopamine receptors is associated with the onset of catatonia in some individuals.

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Author

James Robert Brasic, MD, MPH, MS, MA Assistant Professor, Russell H Morgan Department of Radiology and Radiological Science and Neurology, Division of Nuclear Medicine and Molecular Imaging, Assistant Professor, Department of Neurology, Johns Hopkins University School of Medicine

James Robert Brasic, MD, MPH, MS, MA is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Neurology, International Parkinson and Movement Disorder Society, Society for Neuroscience, Society of Nuclear Medicine and Molecular Imaging

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Johns Hopkins University School of Medicine Serve(d) as a speaker or a member of a speakers bureau for: Society of Nuclear Medicine and Molecular Imaging, Maryland Regional Council of Child and Adolescent Psychiatry Received research grant from: National Institutes of Health, Johns Hopkins University School of Medicine, Intellectual & Developmental Disabilities Research Center (U54 HD079123) at the Kennedy Krieger Institute Received income in an amount equal to or greater than $250 from: Gerson Lehrman Group; Guidepost Received royalty from Medscape for other.

Coauthor(s)

Farzaneh Farhadi, MD Postdoctoral Research Fellow, Johns Hopkins Hospital

Disclosure: Nothing to disclose.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida Morsani College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, American Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Bioserenity, Ceribell, Eisai, Jazz, LivaNova, Neurelis, Neuropace, SK life science, Sunovion, Takeda, UCB Serve(d) as a speaker or a member of a speakers bureau for: Aquestive, Bioserenity, Eisai, Jazz, LivaNova, Neurelis, SK life science, Stratus, Sunovion, UCB Received research grant from: Cerevel Therapeutics, Ovid Therapeutics, Neuropace, Greenwich Jazz, SK Life Science, Xenon Pharmaceuticals, UCB, Marinus, Neuroelectrics Corporation, Longboard, Janssen, Equilibre Biopharmaceuticals.

Acknowledgements

Nestor Galvez-Jimenez, MD, MSc, MHA Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida

Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Acknowledgments

The research for this article was supported by the Essel Foundation; the National Alliance for Research on Schizophrenia and Depression (NARSAD); the Tourette Syndrome Association, Inc; the National Institutes of Health; and the Department of Psychiatry of Bellevue Hospital Center and the New York University School of Medicine, New York, New York. The cooperation of the Health and Hospitals Corporation of the City of New York is gratefully acknowledged.

Catatonia Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

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