Description
Catatonia is a syndrome of motor dysregulation (mutism, peculiar postures, repetitive speech, negativism and imitative movements), and is found in as many as ten per cent of acutely ill psychiatric inpatients. Although its classification has been controversial, the identification of catatonia is not difficult, but it is often missed, leading to the false notion that the syndrome is rare. Catatonia has various presentations, and may be caused by many neurologic and general medical conditions, most commonly mood disorder. Treatments are well defined, and when used, catatonia has an excellent prognosis. This book, by two leading neuropsychiatrists, describes the features of catatonia, teaches the reader how to identify and treat the syndrome successfully, and describes its neurobiology. Patient vignettes from the authors' practices, and many from the classical literature, illustrate the principles of diagnosing and treating patients with catatonia. It is an essential clinical reference for psychiatrists and neurologists.
Chapter
2 Signs of catatonia are identifiable
Features demonstrated in examination
Catatonic spectrum behaviors
3 The many faces of catatonia
Retarded catatonia (Kahlbaum syndrome)
Neuroleptic malignant syndrome variant of malignant catatonia
Delirious mania, excited catatonia, and oneiroid state
4 The differential diagnosis of catatonia
Laboratory tests and catatonia
Conditions in which catatonia is expressed
General medical conditions
Drug-induced (toxic) states
Ganser syndrome (pseudologica fantastica)
Other neurologic diseases
Catatonia in adolescents and children
Conditions that may be mistaken for catatonia
Obsessive—compulsive disorder
Stiff-person syndrome and locked-in syndrome
5 Catatonia is measurable and common
DSM classification of catatonia
An alternative classification for catatonia
Historical basis for change in classification
Frequency of identification
Associated psychopathology
6 Past treatments for catatonia
Other treatments of catatonia
7 Management of catatonia today
Retarded catatonia (Kahlbaum syndrome)
Excited patients with catatonia
Malignant catatonia/neuroleptic malignant syndrome
Benzodiazepine-ECT approach
Dopaminergic-muscle relaxant approach
Useful treatment techniques in malignant catatonia/neuroleptic malignant syndrome
Benzodiazepine challenge and treatment
Electroconvulsive therapy
Electroconvulsive therapy-induced electroencephalogram changes
Maintenance treatment protocol
Schizophrenia and catatonia
Catatonia in other conditions
8 The neurology of catatonia
Neurochemical aberrations
Synthesis and clinical implications
Catatonia is a stable syndrome
Neuroleptic malignant syndrome is malignant catatonia
Catatonia is not usually associated with schizophrenia
Catatonia is a good-prognosis condition
Catatonia is a syndrome of motor dysregulation
What can the study of catatonia teach us?
To answer what questions?
I. Rating scale for catatonia
17. Passive obedience (mitgehen)
18. Negativism (Gegenhalten)
23. Autonomic Abnormality
II. Examination for catatonia