Malignant catatonia: role of right unilateral electroconvulsive therapy

Malignant catatonia is defined as a life-threatening febrile neuropsychiatric disorder, characterized by psychosis with autonomic instability, hyperactivity, mutism, and stuperous exhaustion. Although historically nearly always fatal, there has been a recent decline in mortality, secondary to earlier diagnoses and appropriate treatment implementation. This includes administration of standing benzodiazepines, and without timely response to this pharmacological intervention, electroconvulsive therapy is the next appropriate treatment. We present a case of a young woman with malignant catatonia who was successfully treated with right-unilateral electroconvulsive therapy.