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Catatonia

Clinical Features, Differential Diagnosis, and Treatment

  • Chapter
Psychiatry for Neurologists

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Catatonia is a clinical syndrome characterized by a range of psychomotor abnormalities. It was first described in 1875 by Kahlbaum (1) who reported 25 patients with a “brain disease” characterized by four of the following signs: long periods of immobility, mutism alternating with verbigeration, staring, withdrawal and refusal to eat or drink, negativism, posturing and grimacing, echolalia, echopraxia, stereotypy, and waxy flexibility (see Table 1). Kahlbaum observed that these otherwise immobile patients could become very agitated or excited and were often found to have extremes of mood disturbance in the form of “melancholy” or “mania.” This phenomenon of marked, polar alterations in the predominant psychomotor state eventually led to division of the syndrome into retarded and excited types (2). The excited form has been much more difficult to characterize and distinguish from mania (3). In rare instances, patients with severe motor excitement develop fever, autonomic disturbances, stupor, and rhabdomyolysis and may succumb to cardiovascular collapse. This clinical state has been referred to as lethal or malignant catatonia (4,5) and the clinical and laboratory similarities to neuroleptic malignant syndrome (NMS) has generated considerable interest and discussion (6,7).

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Author information

Authors and Affiliations

  1. Department of Psychiatry, McMaster University Hospital, McMaster University Medical School, Hamilton, Ontario, Canada

    Patricia I. Rosebush MD

  2. Department of Neurology, McMaster University Hospital, McMaster University Medical School, Hamilton, Ontario, Canada

    Michael F. Mazurek MD

Authors
  1. Patricia I. Rosebush MD
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  2. Michael F. Mazurek MD
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Editors and Affiliations

  1. Department of Psychiatry and Neurosciences, University of California, San Diego

    Dilip V. Jests MD

  2. Department of Psychiatry and Neurosciences, VA San Diego Healthcare System, San Diego, CA

    Dilip V. Jests MD

  3. Parkinson’s Disease and Movement Disorders Center, NeuroHealth, Warwick, RI

    Joseph H. Friedman MD

  4. University Medical School, Providence, RI

    Joseph H. Friedman MD

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© 2006 Humana Press Inc., Totowa, NJ

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Rosebush, P.I., Mazurek, M.F. (2006). Catatonia. In: Jests, D.V., Friedman, J.H. (eds) Psychiatry for Neurologists. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59259-960-8_8

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  • DOI: https://doi.org/10.1007/978-1-59259-960-8_8

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-483-8

  • Online ISBN: 978-1-59259-960-8

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