Epileptic seizures superimposed on catatonic stupor.
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.
Suzuki
Kazumasa
K
Department of Psychiatry, Tohoku University Hospital, Sendai, Japan. kazumasa-tohoku@umin.ac.jp
Miura
Nobuyoshi
N
Awata
Shuichi
S
Ebina
Yukio
Y
Takano
Takehisa
T
Honda
Tomoko
T
Shindo
Tsuyoshi
T
Matsuoka
Hiroo
H
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
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D010672:Phenytoin; D006220:Haloperidol