Catatonia mimicking nonconvulsive status epilepticus.
Nonconvulsive status epilepticus (NCSE) and catatonia share many clinical features and distinguishing between them on the basis of the physical examination may be difficult and even impossible. Although several reports have been made of NCSE simulating catatonia, there are no published cases of catatonia mimicking NCSE. We report a 24-year-old woman whose initial examination was notable for a fixed stare, no response to voice or command, gaze preference, tonic head posturing, constant stereotypic chewing movements, profuse foamy salivation, and dramatic response to the parenteral administration of benzodiazepines (BZDs). She was initially misdiagnosed as having NCSE. EEG, however, was normal. We believe this is the first published report of catatonia simulating NCSE. The EEg may be more useful than the clinical examination in distinguishing NCSE from catatonia.
Louis
E D
ED
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Pflaster
N L
NL
D000328:Adult; D001569:Benzodiazepines / Q000008:administration & dosage / Q000494:pharmacology; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis; D002389:Catatonia / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D003975:Diazepam / Q000008:administration & dosage / Q000494:pharmacology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D013129:Spinal Puncture; D013226:Status Epilepticus / Q000175:diagnosis*
D001569:Benzodiazepines; D003975:Diazepam