Peritogiannis Vaios, Rizos Dimitrios V
Mobile Mental Health Unit of the prefectures of Ioannina and Thesprotia, Society for the Promotion of Mental Health in Epirus, Ioannina, Greece.
Intensive Care Unit, "Hatzikosta" General Hospital, Ioannina, Greece.
Clin Pract Epidemiol Ment Health. 2021 May 24;17:26-30. doi: 10.2174/1745017902117010026. eCollection 2021.
Catatonia is a syndrome of altered motor behavior that is mostly associated with general medical, neurologic, mood and schizophrenia-spectrum disorders. The association of newly onset catatonic symptoms with hyponatremia has been rarely reported in the literature.
We present a rare case of a young female patient with schizophrenia, who presented with catatonic symptoms in the context of hyponatremia due to water intoxication. The symptoms were eliminated with the correction of hyponatremia. There are only a few reports of hyponatremia-associated catatonia in psychiatric and non-psychiatric patients. Sometimes, catatonic symptoms may co-occur with newly onset psychotic symptoms and confusion, suggesting delirium. In several cases, the catatonic symptoms responded to specific treatment with benzodiazepines or electroconvulsive therapy.
Hyponatremia may induce catatonic symptoms in patients, regardless of underlying mental illness, but this phenomenon is even more relevant in patients with a psychotic or mood disorder, which may itself cause catatonic symptoms. It is important for clinicians not to attribute newly-onset catatonic symptoms to the underlying psychotic or mood disorder without measuring sodium serum levels. The measurement of sodium serum levels may guide treating psychiatrists to refer the patient for further investigation and appropriate treatment.
紧张症是一种运动行为改变的综合征，主要与躯体疾病、神经系统疾病、心境障碍及精神分裂症谱系障碍相关。文献中很少报道新发紧张症症状与低钠血症之间的关联。
我们报告一例罕见的年轻女性精神分裂症患者，该患者因水中毒导致低钠血症，并出现紧张症症状。低钠血症纠正后症状消失。在精神科和非精神科患者中，仅有少数关于低钠血症相关性紧张症的报道。有时，紧张症症状可能与新发精神病性症状及意识模糊同时出现，提示谵妄。在一些病例中，紧张症症状对苯二氮䓬类药物或电休克治疗有反应。
低钠血症可能在患者中诱发紧张症症状，无论其潜在精神疾病如何，但这种现象在患有精神病性或心境障碍的患者中更为常见，而这些疾病本身也可能导致紧张症症状。临床医生在未检测血清钠水平的情况下，不应将新发紧张症症状归因于潜在的精神病性或心境障碍，这一点很重要。血清钠水平的检测可能会指导精神科治疗医生将患者转诊进行进一步检查和适当治疗。
