Catatonia as an unusual presentation of posttraumatic stress disorder

A patient with posttraumatic stress disorder (PTSD) had several episodes of catatonia in the past 44 years. These episodes were characterized by a sudden onset of intense excitement, mild pyrexia, often moderate elevation of serum creatinine phosphokinase and the development of a full catatonic state. We could not relate the symptomatology exhibited to any one of the accepted etiologies of catatonia. We assume, following careful evaluation of the clinical picture, and thorough biochemical and imaging work-up, that in this case the catatonic states represented an overwhelming psychic response to associated traumatic recollections, bringing to extreme the avoidance, numbness and motor responses usually encountered in PTSD.