Reversal of preoperative catatonic state by surgical resection of an adult-onset craniopharyngioma: case report and review of the literature.
OBJECTIVE
To describe a case of a rare adult-onset craniopharyngioma presenting as rapidly progressive catatonia that was reversed after surgical resection of the tumor.


BACKGROUND
Profoundly depressed states of awareness classified as either catatonia or akinetic mutism have been reported in patients with hypothalamic neoplasms, but reports of improvement in consciousness level after surgical resection are rare and limited to very large tumors.


METHODS
Medical, neurologic, and psychiatric histories, physical examination findings, laboratory workup results, pathologic and imaging studies, and response to surgical treatment were documented.


RESULTS
The patient showed progressive improvement in mental status and overall neurologic function after surgical treatment.


CONCLUSIONS
The search for an etiology of a profound catatonic state should include the probability of a suprasellar/hypothalamic lesion, which in this case was owing to the rare finding of an imaging-documented adult-onset craniopharyngioma.
Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA.
Justin
J
Massengale
Bashir Akhavan
BA
Tafti
Lisa
L
Large
Stephen
S
Skirboll
D001921:Brain / Q000473:pathology; D002389:Catatonia / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D003397:Craniopharyngioma / Q000150:complications* / Q000601:surgery*; D006728:Hormones / Q000097:blood; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010911:Pituitary Neoplasms / Q000150:complications* / Q000601:surgery*; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology
D006728:Hormones; D006993:Hypnotics and Sedatives; D008140:Lorazepam