Catatonia :A Clinician's Guide to Diagnosis and Treatment

Publication subTitle :A Clinician's Guide to Diagnosis and Treatment

Author: Max Fink; Michael Alan Taylor  

Publisher: Cambridge University Press‎

Publication year: 2006

E-ISBN: 9780511055652

P-ISBN(Paperback): 9780521032360

Subject: R749.7 neurosis

Keyword: 神经病学与精神病学

Language: ENG

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Catatonia

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

Catatonia disappears

Interest revives

Present status

ENDNOTES

2 Signs of catatonia are identifiable

Mutism

Stupor

Excitement

Features demonstrated in examination

Catatonic spectrum behaviors

ENDNOTES

3 The many faces of catatonia

Introduction

Subtypes of catatonia

Retarded catatonia

Excited catatonia

Malignant catatonia

Periodic catatonia

Primary akinetic mutism

Retarded catatonia (Kahlbaum syndrome)

Malignant catatonia

Neuroleptic malignant syndrome variant of malignant catatonia

Delirious mania, excited catatonia, and oneiroid state

Mixed affective states

Periodic catatonia

Toxic serotonin syndrome

Benign stupor

Primary akinetic mutism

ENDNOTES

4 The differential diagnosis of catatonia

Laboratory tests and catatonia

Electroencephalography

Neuroendocrine tests

Other laboratory tests

Conditions in which catatonia is expressed

Mania

Depression

Non-affective psychosis

General medical conditions

Drug-induced (toxic) states

Epilepsy

Ganser syndrome (pseudologica fantastica)

Other neurologic diseases

Metabolic disorders

Catatonia in adolescents and children

Conditions that may be mistaken for catatonia

Mutism

Stupor

Parkinson disease

Obsessive—compulsive disorder

Malignant hyperthermia

Stiff-person syndrome and locked-in syndrome

ENDNOTES

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

Factor analytic studies

Rating scales

ENDNOTES

6 Past treatments for catatonia

Fever therapy

Barbiturates

Benzodiazepines

Insulin coma therapy

Convulsive therapy

Other treatments of catatonia

ENDNOTES

7 Management of catatonia today

Acute treatment

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

Toxic serotonin syndrome

Treatment failure

Electroconvulsive therapy-induced electroencephalogram changes

Maintenance treatment protocol

Depression and catatonia

Schizophrenia and catatonia

Catatonia in other conditions

Additional strategies

Prophylaxis

ENDNOTES

8 The neurology of catatonia

Motor system dysfunction

Neurochemical aberrations

Epilepsy model

Synthesis and clinical implications

ENDNOTES

9 Back to the future

Catatonia is a stable syndrome

Catatonia is common

Catatonia has many faces

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

Future studies

What can the study of catatonia teach us?

To answer what questions?

ENDNOTES

Appendices

I. Rating scale for catatonia

1. Excitement

2. Immobility/Stupor

3. Mutism

4. Staring

5. Posturing/Catalepsy

6. Grimacing

7. Echopraxia/Echolalia

8. Stereotypy

9. Mannerisms

10. Verbigeration

11. Rigidity

12. Negativism

13. Waxy Flexibility

14. Withdrawal

15. Impulsivity

16. Automatic Obedience

17. Passive obedience (mitgehen)

18. Negativism (Gegenhalten)

19. Ambitendency

20. Grasp Reflex

21. Perseveration

22. Combativeness

23. Autonomic Abnormality

II. Examination for catatonia

References

Index

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