Definition

What is catatonia?

Catatonia is a psychomotor disorder. It affects a person’s ability to move in a normal way. Affected people can experience a variety of symptoms. The most common symptom is stupor, which means that the patient cannot move, speak, or respond to stimuli. However, some catatonia sufferers may show excessive movement and violent behavior.

Catatonia can last anywhere from just hours to as many as 10 days. It can reoccur frequently for weeks to years after the initial episode. If catatonia is a symptom of an identifiable cause, it is designated as extrinsic. If no cause can be determined, it is considered intrinsic.

Mental health professionals classify catatonia into three categories: retarded, malignant, and excited.

  • Retarded catatonia is the most common catatonia form. It causes slow movement. A patient may stare into space and often does not speak.
  • Patients with malignant catatonia are delirious. They often have a fever. They may also have a fast heartbeat and high blood pressure.
  • Patients with excited catatonia appear “sped up.” They are restless and agitated. They are sometimes aggressive.

How common is catatonia?

The current frequency of catatonia in international populations is unknown. The few published epidemiologic studies have reported vastly different rates, suggesting that the frequency of catatonia may vary widely from one location to another. On the other hand, many cases of catatonia may remain undiagnosed. Catatonia may be diagnosed less frequently in developing countries than it is in industrialized countries, because clinicians fail to identify the condition in their patients. Catatonia is rare in preadolescent children; it has been reported in adolescents and adults. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of catatonia?

The common symptoms of catatonia are:

  • Stupor (oblivious inability to move or respond to stimuli), catalepsy (rigid body posture)
  • Mutism (little to no verbal communication)
  • Waxy flexibility (body remains in whatever position it is placed by another)
  • Negativism (lack of verbal response)
  • Posturing (holding a posture or position that goes against gravity)
  • Mannerisms (extreme or odd movements and mannerisms)
  • Stereotypy (frequent repetitive movements for no reason)
  • Agitation (for no reason), grimacing (distorted facial expressions)
  • Echolalia (repeating others’ words)
  • Echopraxia (repeating others’ movements).

Other common symptoms include rigidity and automatic obedience. When catatonia is associated with schizophrenia, stupor may continue for long periods of time as compared to schizophrenia associated with other psychiatric conditions, where there are likely to be long remissions.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes catatonia?

Common causes of catatonia include mental disorders, post-traumatic stress disorder, and Parkinson’s disease.

Catatonia is a rarely seen side effect of some medications used to treat mental illnesses. (If you suspect that a medication is causing catatonia, seek immediate medical attention. This is considered a medical emergency.)

Withdrawal from some medications, such as clozapine, can cause catatonia.

Imaging studies have revealed that some people with chronic catatonia may have brain abnormalities. This is especially true of the frontal lobes or thalamus.

Another theory is that having excess or too few neurotransmitters causes catatonia. Neurotransmitters are brain chemicals that carry messages from one neuron to the next. One theory is that a sudden reduction in dopamine, a neurotransmitter, causes catatonia. Another theory is that a reduction in gamma-aminobutryic acid (GABA) leads to the condition.

 

Risk factors

What increases my risk for catatonia?

There are many risk factors for catatonia, such as:

  • Female gender
  • Old age
  • Schizophrenia
  • Post-partum depression
  • Cocaine use
  • Low salt concentration in the blood
  • Use of certain medications like ciprofloxacin.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is catatonia diagnosed?

No definitive test for catatonia exists. To diagnose catatonia, a physical exam and testing must first rule out other conditions. The Bush-Francis Catatonia Rating Scale (BFCRS) is a test often used to diagnose catatonia. This scale has 23 items scored from 0 to 3. A “0” rating means the symptom is absent. A “3” rating means the symptom is present. Patients with high rankings on the BFCRS usually respond well to benzodiazepene treatments.

Blood tests can help to rule out electrolyte imbalances. These can cause changes in mental function. A pulmonary embolism or blood clot in the lungs can lead to catatonia symptoms. A fibrin D-dimer blood test can help diagnose catatonia. If test results are 500 mg/mL, catatonia is likely.

Computed tomography (CT) or magnetic resonance imaging (MRI) scans allow physicians to view the brain. This helps to rule out a brain tumor or swelling.

How is catatonia treated?

Medications are usually the first approach to treating catatonia. They include:

  • Amobarbitol
  • Benzodiazepines (such as clonazepam, lorazepam, and midazolam)
  • Bromocriptine
  • Carbamazepine
  • Lithium carbonate
  • Muscle relaxants
  • Reserpine
  • Thyroid hormone
  • Tricyclic antidepressants
  • Zolpidem

Benzodiazepines are usually the first medications prescribed. These medications increase GABA in the brain. This supports the theory that reduced GABA leads to catatonia. After five days, if there is no response to the medication or if symptoms worsen, a physician may recommend other treatments. These include electroconvulsive treatment (ECT).

Electroconvulsive therapy (ECT) is a common treatment for catatonia. This therapy is performed in a hospital under medical supervision. It is a painless procedure. Once a patient is sedated, a special machine delivers an electric shock to the brain. This induces a seizure in the brain for a period of one to two minutes. The seizure alters the flow of neurotransmitters in the brain. This can improve catatonia symptoms.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage catatonia?

The following lifestyles and home remedies might help you cope with catatonia:

  • Learning about your health or disease condition is certain to empower you and encourage you to follow your treatment plan.
  • Search for healthy ways to say energetic, include your hobbies, recreational activities and exercise.
  • Learning stress management and relaxation is the most important coping mechanism. Try techniques of stress-reduction such as meditation or yoga.
  • Plan your daily activities and stay organized. This may be helpful if you plan your time and prepare a list of daily tasks.
  • Observe the warning signs. There may be signs triggering your condition. Plan accordingly so that in case the symptoms return, you must know to handle it immediately.
  • Avoiding alcohol and drugs. Illicit drugs and alcohol may worsen your symptoms. Consider appropriate treatment for such abuse problem.
  • Taking medicines as directed and never skip your medications.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: February 20, 2019 | Last Modified: February 20, 2019

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