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Catatonia and epilepsy: An underappreciated relationship
Jonathan P Rogers1, Simon Shorvon2, James Luccarelli3
1Division of Psychiatry, University College London, London, UK.
Epilepsy & Behavior : E&B
|August 25, 2024
Summary
Catatonia, a syndrome with diverse symptoms, may be linked to underlying seizure activity more often than previously thought. Further investigation, potentially with intracranial EEG, is needed to identify these seizures.
Area of Science:
- Neurology
- Psychiatry
Background:
- Catatonia is a complex syndrome with varied motor, verbal, and behavioral symptoms.
- Current understanding suggests seizure activity underlies approximately 2% of catatonia cases.
- Electroencephalographic (EEG) abnormalities, including background slowing, are frequent in catatonia.
Purpose of the Study:
- To explore the potential underdiagnosis of seizure activity in catatonia.
- To review the temporal relationships between catatonia and seizures.
- To highlight the diagnostic challenges and potential for advanced EEG in identifying seizure activity.
Main Methods:
- Literature review of existing studies on catatonia and seizure activity.
- Analysis of temporal relationships: ictal, postictal, and interictal catatonia.
- Discussion of EEG findings and limitations in diagnosing subtle seizure activity.
Main Results:
- Seizure activity can manifest as ictal, postictal, or interictal catatonia.
- EEG abnormalities are common, even in presumed psychiatric catatonia.
- Intracranial EEG may be necessary for detecting underlying seizures.
Conclusions:
- Evidence suggests a higher prevalence of underlying seizure activity in catatonia than currently recognized.
- Catatonia may present as a manifestation of non-convulsive status epilepticus.
- Further research and advanced diagnostic techniques are crucial for accurate diagnosis and treatment.
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