[Diagnostic difficulties and efficacy of electroconvulsive therapy in the treatment of lethal catatonia]

This publication presents a case of 38-year old woman suffering from schizophrenia, whose body temperature reached 41 degrees C after she had taken 1250 mg of levomepromazine during a suicide attempt. Initially, the dominant symptoms were quantitative and qualitative disturbances of consciousness and periodically increased psychomotor activity, negativism, hallucinations, delusions, schizophrenic disturbances of affect became prominent. When the patient was hospitalized on the internal diseases ward, only symptomatic treatment was conducted, while the cause of the patient's high temperature was still investigated. Only when acute lethal catatonia was diagnosed and ECT was used, did the patient recover. In the event of rapid onset of high temperature in a patient with a mental disorder, a possibility of acute lethal catatonia must be always considered. A differential diagnosis of this disorder with neuroleptic malignant syndrome is very important, as the treatment is quite different. Many M.D.s aren't aware that high body temperature may be a symptom of a mental disease.