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Catatonia in Children Following Systemic Illness
Sadanandavalli Retnaswami Chandra1, Thomas Gregor Issac2, Sumanth Shivaram1
1Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Indian Journal of Psychological Medicine
|December 25, 2015
Summary
Catatonia, a condition of motor and verbal unresponsiveness, often follows infections. Prompt lorazepam treatment is effective, especially in children, leading to significant recovery.
Area of Science:
- Neurology
- Psychiatry
- Pediatrics
Background:
- Catatonia, described in 1874, presents with diverse organic and psychiatric causes.
- A key characteristic is the consistent response to lorazepam, regardless of etiology.
- This study focuses on catatonia in children following febrile illnesses.
Purpose of the Study:
- To investigate the presentation and outcomes of catatonia in children post-febrile illness.
- To highlight the diagnostic utility of lorazepam challenge and early treatment initiation.
Main Methods:
- Evaluation of four pediatric patients with verbal and motor unresponsiveness after febrile illness.
- Diagnosis confirmed using DSM-5 criteria and the Bush-Francis Catatonia Screening Instrument.
- Assessment for infectious and metabolic etiologies.
Main Results:
- All four patients were female and experienced preceding systemic or central nervous system infections.
- Three of the four patients achieved independence within one month of treatment.
- Lorazepam challenge test proved diagnostic.
Conclusions:
- Catatonia should be a differential diagnosis for unexplained verbal and motor unresponsiveness in children.
- Early treatment initiation, particularly with lorazepam, yields rewarding short-term outcomes.
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