Acute Catatonia Following a Cerebellar Stroke: A Case Report

Catatonia can present with a wide spectrum of psychomotor symptoms and should be considered in the differential diagnosis of hospitalized patients with speech and motor difficulties. Catatonia is defined as the presence of three or more of the following: catalepsy, waxy flexibility, stupor, agitation, mutism, negativism, posturing, mannerisms, stereotypies, grimacing, echolalia, and echopraxia. In this case, a 72-year-old black woman was admitted with difficulty with speech and ambulation and found to have a cerebellar stroke on a brain MRI. However, her symptoms of variable rigidity, mutism, and marked psychomotor slowing were not attributable to the small left-sided cerebellar infarction on imaging. A dramatic response to a lorazepam challenge confirmed a diagnosis of acute catatonia secondary to a medical condition.