Kothari Shiva, Khan Basim Ahmed, Nguyen Molly, Gleason Sara H
Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS 39216, USA.
J Med Cases. 2024 Dec;15(12):382-386. doi: 10.14740/jmc4327. Epub 2024 Oct 30.
This is a case report of a previously healthy 26-year-old female with unexplained neurological symptoms that eventually developed malignant catatonia. Because malignant catatonia has a range of clinical manifestations, making prompt diagnosis a challenging task. Due to her relapsing symptoms, the patient was admitted to the inpatient psychiatric unit three times in less than 2 months, and eventually recovered with high doses of lorazepam and several electroconvulsive therapy (ECT) treatments after a stay in the intensive care unit (ICU). This case highlights the importance of avoiding of antipsychotics with dopamine blockade prior to administering a standardized catatonia rating scale in patients with negative symptoms, especially those who have unexplained neurological symptoms or vital sign abnormalities. It also emphasizes the importance of definitive decision-making in pursuing ECT treatment for patients with suspected malignant catatonia, as our patient showed remarkable improvement after ECT. Ultimately, more research is needed to study this rare illness to standardize procedures for treatment of malignant catatonia.
这是一例先前健康的26岁女性病例报告，该患者出现不明原因的神经症状，最终发展为恶性紧张症。由于恶性紧张症有一系列临床表现，迅速诊断是一项具有挑战性的任务。由于症状反复，该患者在不到2个月的时间里3次入住精神科住院病房，最终在重症监护病房（ICU）住院一段时间后，通过大剂量劳拉西泮和多次电休克治疗（ECT）康复。该病例强调了在对有阴性症状的患者，尤其是那些有不明原因神经症状或生命体征异常的患者，在使用标准化紧张症评定量表之前避免使用具有多巴胺阻断作用的抗精神病药物的重要性。它还强调了对疑似恶性紧张症患者进行ECT治疗时做出明确决策的重要性，因为我们的患者在ECT治疗后有显著改善。最终，需要更多研究来研究这种罕见疾病，以规范恶性紧张症的治疗程序。
