Treatment of a Prader-Willi Patient with Recurrent Catatonia

Area of Science:

• Genetics
• Neurology
• Psychiatry

Background:

• Prader-Willi syndrome is a complex genetic disorder with varied clinical manifestations.
• Individuals with Prader-Willi syndrome, particularly maternal uniparental disomy, face an elevated risk for psychosis.
• Catatonia is a severe neuropsychiatric syndrome that can occur in Prader-Willi syndrome.

Purpose of the Study:

• To report the treatment course of a 24-year-old female with Prader-Willi syndrome and recurrent catatonia.
• To illustrate the complexities and challenges in managing catatonia within the context of Prader-Willi syndrome.

Main Methods:

• Case report detailing the clinical presentation and treatment interventions.
• Initial assessment included a lorazepam challenge test.
• Treatment involved benzodiazepines and subsequently electroconvulsive therapy (ECT).

Main Results:

• The patient initially responded to a lorazepam challenge test but failed benzodiazepine treatment.
• Eight sessions of electroconvulsive therapy (ECT) led to initial improvement in catatonic symptoms.
• Symptom resolution was not linear, characterized by periods of improvement followed by relapse.

Conclusions:

• Treatment of catatonia in Prader-Willi syndrome can be complex and challenging.
• Electroconvulsive therapy (ECT) may provide partial and temporary relief for catatonia in this population.
• Further research is needed to establish optimal treatment strategies for catatonia in Prader-Willi syndrome.