Department of Internal Medicine, Facultad de Ciencias Médicas, Universidad de Cuenca, Cuenca, Ecuador.
Department of Internal Medicine, Doctors Hospital at Renaissance DHR Hospital, McAllen, United States of America.
Rev Colomb Psiquiatr (Engl Ed). 2024 Apr-Jun;53(2):206-209. doi: 10.1016/j.rcpeng.2022.02.006.
Catatonia is a rare neuropsychiatric condition; it is estimated that around 10% of patients with mood disorders present signs and symptoms of catatonia. A catatonic syndrome is characterised by mutism, negativism, rigidity, and stupor.
We report the case of a 59-year-old patient with a medical history of bipolar disorder who was admitted to the internal medicine service due to a seizure episode. During hospitalisation, the patient presented significant worsening of her clinical condition, showing marked symptoms of stupor and catatonia. Once the neurological and metabolic etiologies of altered mental status had been ruled out, pharmacological treatment with high doses of lorazepam was started. The patient had a complete clinical remission, and her evolution was favourable without any complications. Electroconvulsive therapy was recommended as a definitive treatment.
The diagnosis of catatonia is a challenge for both hospitalists and psychiatrists due to the clinical presentation of catatonia. In reporting this clinical case, we want to emphasise the importance of taking into account the catatonic syndrome in our differential diagnoses in patients with altered mental status.
紧张症是一种罕见的神经精神疾病；据估计，约 10%的心境障碍患者存在紧张症的体征和症状。紧张症综合征的特征是缄默、抗拒、僵硬和昏迷。
我们报告了一例 59 岁的患者，有双相情感障碍病史，因癫痫发作而被收入内科。住院期间，患者的临床状况明显恶化，表现出明显的昏迷和紧张症症状。在排除了精神状态改变的神经和代谢病因后，开始使用高剂量劳拉西泮进行药物治疗。患者完全临床缓解，病情进展良好，无任何并发症。建议电休克治疗作为确定性治疗。
由于紧张症的临床表现，紧张症的诊断对内科医生和精神科医生来说都是一个挑战。在报告这个临床病例时，我们强调了在精神状态改变的患者的鉴别诊断中考虑紧张症综合征的重要性。
