Related Experiment Video

Updated: Jun 12, 2026

Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
07:35

Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale

Published on: July 8, 2025

[Patient with encephalitis presenting with olanzapine-responsive malignant catatonia]

Hayato Suzuki1, Takao Fukushima, Kunihiko Makino

  • 1Department of Neurology, Shibata Hospital-Niigata Preferctural Hospital.

Rinsho Shinkeigaku = Clinical Neurology
|June 12, 2010
PubMed

Insights

A young man with acute encephalitis developed malignant catatonia, a rare neurological condition. Oral olanzapine effectively treated his severe symptoms, including mutism and muscle rigidity.

Area of Science:

  • Neurology
  • Neuroscience
  • Critical Care Medicine

Background:

  • Acute encephalitis can present with diverse neurological symptoms.
  • Malignant catatonia is a severe, life-threatening syndrome characterized by motor disturbances, autonomic instability, and altered consciousness.

Observation:

  • A 29-year-old man initially presented with memory deficits and emotional instability, diagnosed as acute encephalitis.
  • His condition progressed to malignant catatonia, exhibiting mutism, akinetism, catalepsy, hyperpyrexia, muscle rigidity, dysphagia, respiratory insufficiency, and rhabdomyolysis.
  • Cerebrospinal fluid analysis revealed lymphocytic pleocytosis, and electroencephalogram showed frontal slow activities.

Findings:

  • Standard treatments for encephalitis and catatonia, including acyclovir, methylprednisolone, antibiotics, diazepam, and dantrolene sodium, were ineffective.
  • The patient showed significant clinical improvement after initiating oral olanzapine.
  • Magnetic resonance imaging (MRI) of the brain was normal despite severe neurological symptoms.

Implications:

  • This case highlights the potential efficacy of olanzapine in managing malignant catatonia, even in refractory cases.
  • It underscores the importance of considering malignant catatonia in the differential diagnosis of severe neurological deterioration following encephalitis.
  • Further research is warranted to elucidate the neurobiological mechanisms underlying olanzapine's therapeutic effect in malignant catatonia.

Related Concept Videos

Psychosis: Goals of Pharmacotherapy01:26

Psychosis: Goals of Pharmacotherapy

Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Mania and Antimanic Drugs: Overview01:24

Mania and Antimanic Drugs: Overview

Mania, a psychological condition characterized by elevated mood, increased energy, and reduced sleep need, is part of the bipolar disorder cycle. The exact cause of mania isn't entirely known, but it is thought to be a combination of genetic, environmental, and neurological factors. Bipolar disorder involves alternating manic and depressive episodes. Mood stabilizers like lithium, antipsychotics, and anticonvulsants help manage these episodes. Lithium carbonate is particularly effective as a...
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Seizures: Classification01:13

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Psychosis and Antipsychotic Drugs: Overview01:28

Psychosis and Antipsychotic Drugs: Overview

The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic symptoms in all...