Catatonia in a Possible Case of Moderate Neuroleptic Malignant Syndrome: A Case Report

Background and Clinical Significance: Neuroleptic malignant syndrome (NMS) is a life-threatening condition usually caused by the exposure to antipsychotics. This case report presents a catatonia syndrome that may have developed in the context of a moderate NMS. Case Presentation: An 18-year-old male patient presented with a treatment-resistant catatonia syndrome that debuted 2 weeks prior to the presentation (creatin kinase levels = 4908 U/L, maximum temperature = 38.9°C, white blood count = 13.20 × 10⁹/L, Bush-Francis Catatonia Rating Scale = 30 points). Possible organic causes of catatonia were ruled out, according to the negative results obtained. The patient's condition improved under benzodiazepine treatment and he was later discharged. After discharge, the catatonia was attributed to a possible NMS with moderate severity. The diagnosis was supported by NMS Diagnosis Criteria Score = 85 points and the presence of Levenson's triad. Conclusions: This case highlights the concomitant manifestation of both catatonia and NMS in the same patient and the difficulty of establishing a correct diagnosis involving both entities.