Catatonia

• Catatonia is a state in which someone is awake but does not seem to respond to their environment
• Psychiatric causes:

  • Schizophrenia
  • Mood disorders - depression and bipolar
  • OCD
  • PTSD
  • Psychosis
  • Dissociative disorders
• The pathophysiology of catatonia is not fully understood

  It is thought to be due to imbalances in the neurotransmitters GABA, glutamate and dopamine
• Characteristics:

  • Immobility - resistance to being moved
  • Mutism
  • Stupor - type of altered consciousness
  • Posturing and catalepsy - when holding an unnatural position against gravity. Posturing is done purposely and catalepsy happens passively
  • Waxy flexibility - will allow someone to move you but then will remain in that position
  • Echolalia - repeat words said to you
  • Echopraxia - mimic someone's movements
  • Stereotypies - frequent and repetitive movements
• Management:

  • First line is lorazepam (benzodiazepine)
  • ECT
• Stupor:

  state of decreased responsiveness where a person can only be aroused by vigorous, physical stimulation and quickly lapses back into unresponsiveness when the stimulation stops