[Acute life-threatening catatonia]

Malignant catatonia is a rare, life-threatening syndrome that occurs in connection with somatic as well as psychiatric disorders, in particular with functional psychosis. Key symptoms are catatonic features combined with elevated muscle tone, hyperthermia, vegetative instability, and pathological laboratory values. Benzodiazepines, dantrolene, and ECT have been reported to be an effective treatment of malignant catatonia, whereas classic neuroleptics and anticholinergic drugs are contraindicated. If antipsychotic treatment is required, clozapine is generally used. In this article we describe a case of malignant catatonia in a 52 year old female patient and discuss the clinical picture, the treatment, and the time course of the syndrome.