Catatonia

Catatonia is a complex neuropsychiatric syndrome characterized by a broad range of motor, speech and behavioral abnormalities. It is a behavioral syndrome marked by an inability to move normally despite full physical capacity to do so. ‘Waxy flexibility', ‘posturing' and ‘catalepsy' are among the well-recognized motor abnormalities associated with catatonia. However, there is a wide spectrum of speech and other neurological abnormalities seen in this condition.

Catatonia is often thought to precipitate secondary to another underlying illness. Psychiatric disorders can present primarily with symptoms of catatonia. Mood disorders such as bipolar disorder and depression are the most common disorders in which catatonia manifests. A psychotic disorder such as schizophrenia can also be associated with catatonia, and historically schizophrenia recognition and diagnosis included symptoms of catatonia or was subtyped if catatonic symptoms were present. When catatonic symptoms present, the cause is likely psychiatric, but many medical etiologies can lead to catatonia.

Symptoms

·         Not responding to other people or your environment (negativism)

·         Not speaking (mutism)

·         Holding your body in an unusual position (posturing)

·         Resisting people who try to adjust your body (wavy flexibility)

·         Acting upset or irritable (agitation)

·         Repetitive, seemingly meaningless movement (mannerism)

·         Mimicking someone else’s speech (echolalia)

·         Mimicking someone else’s movements (echopraxia)

·         Keeping the same facial expression, which sometimes looks like a stiff, inappropriate smile (grimacing)

·         Repeated movements that don't seem to have a purpose, such as playing with your fingers or patting and rubbing your body (stereotypy)

Types

Akinetic catatonia: This is the most common. Someone with akinetic catatonia often stares blankly and doesn’t respond when you speak to them. If they do respond, it may only be to repeat what you said. Sometimes, they sit or lie in an unusual position and don’t move

Excited catatonia: With this type, the person may move around, but their movement seems pointless and impulsive. They may seem agitated, combative, or delirious, or they may mimic the movements of someone who’s trying to help them

Malignant catatonia: This type happens when the symptoms lead to other health problems, such as dangerous changes in blood pressure, body temperature, or breathing or heart rate