Catatonia is a medical condition that has been recognized for centuries. It can be debilitating and life-threatening, but it is also completely treatable with the right diagnosis and treatment.
Catatonia is a condition in which patients are immobile or have significant reduction in motor activity. It’s also characterized by the inability to speak coherently, slow movements, and an expressionless face. Catatonia can be caused by various factors such as drugs, alcohol withdrawal, depression, schizophrenia, Parkinson’s disease and other medical conditions. This article provides insight into what catatonia is and how it can be treated effectively with therapy that addresses underlying causes of symptoms.
Types of catatonia
There are three types of catatonia:
- Akinetic catatonia:
- Excited catatonia.
- Malignant catatonia.
Excited catatonia: this is when the person has a lot of energy. They will do things like jumping, making loud noises and run around without any regard to their own safety.
Malignant catatonia: this type involves severe agitation and restlessness which typically occurs in patients with schizophrenia, bipolar disorder or other psychiatric conditions. People with a high risk of suicide should be regularly monitored for signs of malignant catatonia.
Akinetic Catatonia: this is when the person has little or no energy and they will typically remain motionless.
People with both excited and akinetic forms of catatonia are more likely to kill themselves than people with only one type of catatonia. A common cause of suicide is malignant catatonia, which features an intense urge to move, agitation or restlessness.
Patients with malignant catatonia are also at risk of developing neuroleptic malignant syndrome (NMS), a severe adverse reaction to dopamine antagonists such as antipsychotics. Patients who develop NMS will have severely elevated body temperature, altered mental state and motor restlessness.
Symptoms and Diagnosis
These are about some of the more common conditions that can cause catatonia. Catatonia may also be the result of medical procedures like metabolic disturbance, alcohol withdrawal, or some types of infections. It’s even more likely to occur if the patient has any pre-existing neurological conditions like tardive dyskinesia or neuroleptic malignant syndrome
There are some physical examination findings that may be indicative of catatonia:
– Stupor or unresponsiveness
– Excitement or agitation, which is also a possible medical emergency if it’s too extreme
– Inappropriate smiling or laughing for the situation at hand
– Gaze avoidance when someone tries to make eye contact with them
– Rigidity of the body parts like arms and legs when a person tries to move them
– Tongue clicking or grunts that aren’t a reaction to anything in particular
The person may also be unable to react appropriately when they’re being talked to. They may have long pauses, misspeak words, talk in a monotone pitch and lack any type of intonation or emphasis on certain syllables.
If a person has these symptoms, they may be diagnosed as catatonic:
list the symptoms of catatonic
– Lack of motor activity
– Absence of speech
– Emotionless or stony facial expression
– Incorrect or unusual posturing
– Resistance to instructions or attempts to be moved
– Negativism, which is the most common symptom and occurs when a person refuses to respond even though he can hear what’s being said. He also shows no reaction when his name is called
The patient may appear as if they are in a trance or in a state of disbelief about their surroundings. This often occurs when the person is hallucinating, disoriented or depressed
It’s important to note that catatonia isn’t necessarily indicative of schizophrenia – it can be caused by other things too
One cannot diagnose someone with catatonic behavior without taking into consideration where they are and what’s going on around them. This is because the symptoms may be a reaction to their environment
It’s also important to rule out other psychiatric disorders before presuming that a person has catatonia. In addition, it should always be considered when someone doesn’t show any emotions even though they don’t have schizophrenia or another similar disorder
Causes of catatonia
Some common causes of catatonia are mental disorders, substance abuse, stroke, Parkinson’s disease and schizophrenia. Some other causes are trauma or emotional shock. These are just some of the possible reasons for this disorder, there are others that could also cause it.
Some of the common conditions that can cause catatonic behavior include:
– Schizophrenia: This is a common cause of catatonia. It can make a person hear voices and see things that don’t exist
– Bipolar disorder: The manic episodes associated with this condition may include hallucinations or delusions, which can lead to catatonia if not treated adequately
– Drug abuse: People who abuse certain drugs such as ecstasy, LSD, cannabis, methamphetamine or other stimulants may show catatonic symptoms
– Severe depression: Catatonia is commonly seen in depressive episodes. But if the depression doesn’t respond to treatment for some time, it should be taken seriously as there’s a high risk of suicidal tendencies
– Posttraumatic stress disorder (PTSD) can also cause episodes of catatonia. This is more likely to occur if the person had a severe childhood trauma
– Dysfunction of the autonomic nervous system: The functions controlled by this natator can include blood pressure, heart rate and breathing. If these functions are impaired, it could lead to catatonic episodes
– Brain infections or injuries: These can damage the areas of the brain that control communication between different parts, which may cause catatonia
– Vitamin B deficiency: This is caused by lack of vitamin B1 (thiamine) in the body. If left untreated, it could lead to neurological symptoms such as confusion and stupor.
– Alcohol withdrawal: This is another possible cause of catatonia. If a person with alcohol dependence suddenly stops drinking, they may experience delirium tremens (DTs), which could lead to episodes of catatonia
– Side effects of medication: Drug side effects such as those associated with lithium, haloperidol and valproic acid can also induce episodes of catatonic behavior
– Encephalitis lethargica: This is a condition that causes brain inflammation. It was common in the early 1900s but has become extremely rare since then. Its cause isn’t known yet but it’s thought to be related to the after effects of the flu virus.
– Huntington’s disease: This is a neurodegenerative disorder that damages the nerve cells in the brain. It’s characterized by uncontrolled movements, loss of intellectual functions and changes in mood
– Hypokalemia: This is a condition where there isn’t enough potassium in the blood. If it remains undiagnosed or untreated, it can disturb the normal functioning of
– Parkinson’s disease, which is another neurodegenerative disorder like Alzheimer’s and it affects the movement of a person like muscles and movement.
– Creutzfeldt–Jakob disease, which is a fatal brain disorder
– Serotonin syndrome, which is a condition caused by high levels of serotonin in the brain.
– Neuroleptic malignant syndrome, which is a life-threatening reaction to antipsychotic medication.
Catatonia is typically treated with antipsychotics such as risperidone, olanzapine and haloperidol. Benzodiazepines may also be prescribed to manage the anxiety and agitation that can accompany catatonia. Treatment usually consists of a combination of two medications, which is called the biopsychosocial model. Physical therapy, occupational therapy and electroconvulsive therapy are some of the other alternative methods that may be used to treat catatonia.
There are some medications that can cause catatonia as a side effect, which include:
– Antipsychotic drugs: Drugs with this kind of effect are risperidone, olanzapine, quetiapine and haloperidol
– Lithium: This is used to treat bipolar disorder. Lowering the dose or stopping it completely may help cure catatonia
– Levodopa: This medication is given for Parkinson’s disease
– Anti-anxiety medications: Drugs with this kind of effect are diazepam and alprazolam
– Drugs for heart disease: These include amiodarone, propafenone and encainide
– Anticonvulsants: Drugs with this kind of effect are valproic acid, carbamazepine and phenytoin
– Antidepressants: These medications include bupropion, trazodone and amitriptyline. It can also happen as a withdrawal reaction to antidepressants
– Sedatives and sleep aids: Drugs with this kind of effect are clonazepam, zolpidem and lorazepam.
Conclusion: Catatonia is a rare disorder characterized by abnormal behavior. It can affect people of all age groups, but it’s more common in women. If you have suspicious symptoms, consult your doctor immediately.
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