Catatonic coma with profound bradycardia.
Catatonia may be monosymptomatic at presentation, with stupor or coma as the cardinal and only manifestation. A case of catatonic coma with profound bradycardia is presented to help clinicians recognize this entity and include catatonia in the differential diagnosis of coma as a rare etiology after other more common causes of coma have been excluded. Cases of catatonic coma are nevertheless important to identify because treatment with intravenous benzodiazepines is simple and highly effective. The authors argue that the descriptive term "catatonic coma" is preferable over terms implying psychogenesis, such as "psychogenic" or "hysterical" coma; for catatonia, the authors have a specific treatment, in the form of benzodiazepines; for "psychogenesis," there is none.
Freudenreich
Oliver
O
Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. ofreudenreich@partners.org
McEvoy
Joseph P
JP
Goff
Donald C
DC
Fricchione
Gregory L
GL
D000328:Adult; D001919:Bradycardia / Q000175:diagnosis* / Q000523:psychology; D002389:Catatonia / Q000175:diagnosis* / Q000523:psychology; D003128:Coma / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage; D008297:Male; D012563:Schizophrenia, Paranoid / Q000175:diagnosis / Q000523:psychology
D008140:Lorazepam