Unspecified catatonia presenting to neurology and psychiatry with no detectable organic aetiology

A previously healthy professional athlete in his 20s, with no prior psychiatric or medical history, presented with a 4-day history of rapidly progressive neurological deterioration. This manifested as persistent stupor, mutism and profound psychomotor retardation, enduring several weeks with minimal improvement despite escalating doses of lorazepam (up to 14 mg/day). Extensive investigations at a tertiary neurological centre in the UK revealed no identifiable organic cause. The patient's symptoms ameliorated promptly with the initiation of electroconvulsive therapy in conjunction with lorazepam.