Koprucki Shawna, Morcos Roy
Family Medicine, Mercy Health St. Elizabeth Boardman Hospital, Boardman, USA.
Cureus. 2024 Sep 18;16(9):e69645. doi: 10.7759/cureus.69645. eCollection 2024 Sep.
Catatonia can present with a wide spectrum of psychomotor symptoms and should be considered in the differential diagnosis of hospitalized patients with speech and motor difficulties. Catatonia is defined as the presence of three or more of the following: catalepsy, waxy flexibility, stupor, agitation, mutism, negativism, posturing, mannerisms, stereotypies, grimacing, echolalia, and echopraxia. In this case, a 72-year-old black woman was admitted with difficulty with speech and ambulation and found to have a cerebellar stroke on a brain MRI. However, her symptoms of variable rigidity, mutism, and marked psychomotor slowing were not attributable to the small left-sided cerebellar infarction on imaging. A dramatic response to a lorazepam challenge confirmed a diagnosis of acute catatonia secondary to a medical condition.
紧张症可表现出广泛的精神运动症状，对于存在言语和运动困难的住院患者进行鉴别诊断时应考虑到该病。紧张症的定义为存在以下三种或更多症状：僵住症、蜡样屈曲、木僵、激越、缄默症、违拗症、姿势异常、作态、刻板动作、扮鬼脸、模仿言语和模仿动作。在本病例中，一名72岁黑人女性因言语和行走困难入院，脑部MRI检查发现有小脑梗死。然而，影像学显示其左侧小脑小面积梗死并不能解释她出现的可变僵硬、缄默症和明显精神运动迟缓症状。对劳拉西泮激发试验的显著反应证实了继发于躯体疾病的急性紧张症的诊断。
