Cawkwell Philip B, Mayor Ivan Daniel, Shaw Richard J
Drs. Cawkwell and Shaw and Mr. Mayor are with the Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, at the Stanford University School of Medicine in Palo Alto, California.
Innov Clin Neurosci. 2021 Jan 1;18(1-3):17-20. eCollection 2021 Jan-Mar.
Pediatric catatonia is a complex entity that is easily missed in the hospital setting and seldom reported in the literature. Here, we present the case of a 6-year-old previously healthy female patient who was initially thought to have intractable delirium secondary to disseminated Group A streptococcus (GAS) infection. Careful examination, utilization of the Pediatric Catatonia Rating Scale, and lorazepam challenge were key to elucidating the diagnosis. While GAS is most often associated with pediatric acute-onset neuropsychiatric syndrome (PANS) in the child and adolescent population, we reviewed the limited literature to suggest a mechanism by which it can lead to catatonia. Further systematic study of catatonia in the pediatric population is warranted to better understand pathogenesis and long-term neuropsychiatric outcomes.
儿童紧张症是一种复杂的病症，在医院环境中很容易被漏诊，且在文献中鲜有报道。在此，我们报告一例6岁既往健康的女性患者，她最初被认为患有由A组链球菌（GAS）播散感染继发的难治性谵妄。仔细检查、使用儿童紧张症评定量表以及劳拉西泮激发试验是明确诊断的关键。虽然在儿童和青少年人群中，GAS最常与儿童急性起病神经精神综合征（PANS）相关，但我们查阅了有限的文献，以提出其可导致紧张症的一种机制。有必要对儿科人群中的紧张症进行进一步的系统研究，以更好地了解其发病机制和长期神经精神转归。
