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Case Reports
. 2017 Apr-Jun;11(2):209-212.
doi: 10.1590/1980-57642016dn11-020015.

Catatonia, beyond a psychiatric syndrome

Nathália Stela Visoná de Figueiredo  1 , Débora Bartzen Moraes Angst  1 , Antônio de Matos Lima Neto  1 , Michel Ferreira Machado  1 , Maria Sheila Guimarães Rocha  2 , Sônia Maria Dozzi Brucki  3
Affiliations
Case Reports

Catatonia, beyond a psychiatric syndrome

Nathália Stela Visoná de Figueiredo et al. Dement Neuropsychol. 2017 Apr-Jun.

Abstract
in English, Portuguese

Although catatonia is a well-known psychiatric syndrome, there are many possible systemic and neurological etiologies. The aim of this case report was to present a case of a patient with cerebral venous sinus thrombosis and infarction in which catatonia was the clinical manifestation of a possible nonconvulsive status epilepticus. To our knowledge, only one such case has been reported in the literature, which had a simplified diagnostic investigation. It is important to correctly recognize the organic cause underlying catatonia in order to treat the patient as soon as possible thereby improving outcome. Therefore, physicians need to update their knowledge on catatonia, recognizing that it can be part of a psychiatric or neurologic condition.

Embora a catatonia seja uma síndrome psiquiátrica bem conhecida, existem várias etiologias possíveis, tanto sistêmicas quanto neurológicas. O objetivo deste relato de caso é apresentar um quadro de trombose venosa central com infarto venoso em que a catatonia foi a manifestação clínica de um possível status não convulsivo. Na concepção dos autores, apenas um caso é encontrado na literatura, porém com uma propedêutica simplificada. É importante o correto reconhecimento das causas orgânicas que podem estar causando a catatonia para que sejam corrigidas assim que possível, melhorando o prognóstico do paciente. Além disso, os médicos precisam atualizar seus conhecimentos sobre a catatonia, uma vez que ela pode ser parte tanto de uma condição psiquiátrica quanto neurológica.

Keywords: brain infarction; catatonia; intracranial sinus thrombosis; status epilepticus.

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Conflict of interest statement

Disclosure: The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
[A] Brain CT from admission showing small hyperdense spots within hypodense area in left temporal lobe. [B] At second day, Flair MRI sequence showed hyperintense image in left posterior temporal lobe, suggesting a venous temporal infarct.
Figure 2
Figure 2
EEG performed on the second day at emergency department revealing diffuse disorganization of the cerebral activity with slow waves on left medium-posterior temporal region, involving electrodes T3 and T5, without epileptic activity. Clinical manifestations had totally disappeared after Phenytoin administration, which was before this EEG recording.
Figure 3
Figure 3
Venous brain MRI performed at second day with filling failure from left transverse sinus to ipsilateral jugular vein due to a cerebral venous sinus thrombosis.
See this image and copyright information in PMC

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