Ictal catatonia as a manifestation of nonconvulsive status epilepticus

Three patients with EEG documented ictal catatonia, a nonconvulsive status epilepticus, who responded dramatically to intravenous phenytoin are described. The EEG showed continuous bilateral pseudoperiodic sharp waves and spike discharges in one patient, spike and wave complexes were seen prominently in the right fronto-central region in another, and the EEG of the third patient showed periodic lateralising epileptiform discharges during the catatonic state. We postulate that such catatonia was due to involvement of the limbic system by seizure activity.