Severe catatonia and neuroleptic malignant syndrome: report of 3 cases

Catatonia is a syndrome characterized by motor rigidity or stupor, negativism, mutism and inappropriate or bizarre posture. Without proper management, patients may have significant morbidity and mortality from stupor, coma and death (lethal or malignant catatonia). Neuroleptic malignant syndrome (NMS) is characterized by a sudden appearance of motor rigidity, fever, autonomic effect, increased white blood cell count, serum creatinine phosphokinase, liver enzymes, and myoglobin. The mortality rate is 15 per cent to 25 per cent or even higher when depot form of neuroleptic is used. We report a patient with severe catatonia and two cases of NMS. Death was encountered with one of the latter.