Electroconvulsive therapy-responsive catatonia in a medically complicated patient

Area of Science:

• Neurology
• Psychiatry

Background:

• Catatonia and akinetic mutism are profound states of altered awareness linked to medical conditions like encephalitis or tumors.
• Diagnosing catatonia in these contexts is challenging, potentially leading to premature discontinuation of electroconvulsive therapy (ECT), the most effective treatment.

Observation:

• A patient with squamous cell carcinoma and temporal lobe meningitis developed catatonia after initial ECT treatments for depression.
• Catatonia resolved with continued ECT, alongside improvements in mood, interactivity, and neurological function.

Findings:

• This case highlights that catatonia can emerge during medical treatment and may respond to continued electroconvulsive therapy (ECT).
• Early consideration of ECT is crucial for catatonia, particularly when the underlying cause is unclear or catatonia arises mid-treatment.

Implications:

• The findings underscore the importance of considering underlying medical disorders in catatonic states.
• Electroconvulsive therapy (ECT) should be considered early in catatonia management, even if it develops during ongoing treatment, as it remains a highly effective intervention.