title: Epileptic seizures superimposed on catatonic stupor.
abstract: OBJECTIVE
  Some patients with nonconvulsive status epilepticus are known to exhibit catatonic stupor. Thus it is necessary to rule out ictal catatonia by electroencephalography in patients with catatonic stupor. However, few reports are available on epileptic seizures superimposed on catatonic stupor.
  
  
  METHODS
  We report three cases of epileptic seizures superimposed on psychiatric catatonic stupor without a prominent predisposing factor, including high fever or encephalitis. None of the patients had a personal or family history of neurologic disease, including epilepsy.
  
  
  RESULTS
  In all three patients, catatonic stupor persisted after resolution of the epileptic seizures with administration of phenytoin. In two of the three patients, catatonic stupor resolved with electroconvulsive therapy, which caused no marked adverse effects.
  
  
  CONCLUSIONS
  Because it is possible that catatonic stupor itself predisposes patients to the development of epileptic seizures, electroencephalographic examinations in patients with catatonic stupor are indispensable for early recognition not only of nonconvulsive status epilepticus but also of epileptic seizures superimposed on catatonic stupor. Electroconvulsive therapy deserves consideration when catatonic stupor persists after resolution of epileptic seizures.
authors.affiliation: Department of Psychiatry, Tohoku University Hospital, Sendai, Japan. kazumasa-tohoku@umin.ac.jp
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Suzuki
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Miura
authors.forename: Shuichi
authors.initials: S
authors.lastname: Awata
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ebina
authors.forename: Takehisa
authors.initials: T
authors.lastname: Takano
authors.forename: Tomoko
authors.initials: T
authors.lastname: Honda
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shindo
authors.forename: Hiroo
authors.initials: H
authors.lastname: Matsuoka
mesh_terms: D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D002389:Catatonia / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D004565:Electroconvulsive Therapy; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000627:therapeutic use; D012560:Schizophrenia, Catatonic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D010672:Phenytoin; D006220:Haloperidol