Khalafian Andrey, Dukes Charles, Tucker Phebe
J Okla State Med Assoc. 2015 Aug;108(8):358-60.
Mr. R, a 27 year old Hispanic male with history of traumatic brain injury (TBI) over ten years prior but no psychiatric history, presents to the psychiatric consultation service with recent onset of mutism, psychotic behavior and new diagnosis of epilepsy. The differential diagnosis is broad and includes both medical and psychiatric causes: post-ictal state, non-convulsive status epilepticus, delirium due to metabolic conditions, drugs, catatonia, conversion disorder, major depression with psychotic features, new onset schizophrenia or a combination of these possible diagnoses. We explore different medical causes that can present with symptoms of catatonia, as it is crucial to rule out a possible treatable medical cause.
R先生是一名27岁的西班牙裔男性，十年前有创伤性脑损伤（TBI）病史，但无精神病史，因近期出现缄默症、精神病行为和新诊断的癫痫症，前来精神科会诊服务处就诊。鉴别诊断范围广泛，包括医学和精神科原因：发作后状态、非惊厥性癫痫持续状态、代谢状况、药物所致谵妄、紧张症、转换障碍、伴有精神病性特征的重度抑郁症、新发精神分裂症或这些可能诊断的组合。我们探讨了可出现紧张症症状的不同医学原因，因为排除可能可治疗的医学原因至关重要。
