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Catatonia as a feature of down syndrome: An under-recognised entity?
Aisling Lyons1, Nicholas M Allen1, Orla Flanagan1
1Department of Paediatrics, National University of Ireland Galway, Galway University Hospital, Ireland.
Insights
Catatonia is an under-recognized cause of neurodevelopmental regression in children with Down syndrome. Early recognition and treatment with lorazepam can significantly improve symptoms and function.
Area of Science:
- Neuroscience
- Pediatrics
- Psychiatry
Background:
- Down syndrome is associated with neurodevelopmental challenges.
- Unexplained neurodevelopmental regression presents diagnostic difficulties and morbidity in individuals with Down syndrome.
Observation:
- A series of seven children with Down syndrome presented with developmental regression.
- Symptoms included immobility, mutism, and posturing, which were often overlooked.
- Some children experienced prolonged periods of symptoms and investigation before diagnosis.
Findings:
- Catatonia was the final diagnosis in all seven children.
- Treatment with lorazepam improved symptoms in all cases.
- Some children achieved full reversal of catatonia to their baseline function.
Implications:
- Recognizing catatonia is crucial for timely and effective treatment in children with Down syndrome.
- Lorazepam is an effective treatment for catatonia in this population.
- Autistic traits may be an under-recognized comorbidity in Down syndrome with catatonia.
Abstract:
Children and adults with Down syndrome may experience unexplained neurodevelopmental regression leading to considerable diagnostic uncertainty as well as morbidity. In this study we describe a series of seven children with Down syndrome presenting with developmental regression, some of whom had lengthy periods of symptomatology and investigation prior to a final diagnosis of catatonia. While catatonia typically presents with immobility, mutism and posturing, these symptoms can often be overlooked if not recognised as catatonic phenomena. Treatment with lorazepam led to improvement in symptoms in all, eventually reversing the catatonia in some children to previous baseline function. Autistic traits were present upon retrospective analysis, a potentially under recognised co-morbidity. It is essential to recognise catatonia in children with Down syndrome, as this is an under-recognised, treatable cause of developmental regression.
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