[Patient with encephalitis presenting with olanzapine-responsive malignant catatonia].
We report the case of a 29-year-old man, who could not remember some words of Kanji and showed emotional instability. Magnetic resonance imaging (MRI) scan of his brain appeared normal. Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis. An electroencephalogram (EEG) showed slow activities in both frontal regions of the brain. He was diagnosed as acute encephalitis. On his fourth hospital day, he was found to be catatonic and showed mutism, akinetism, and catalepsy. On the ninth day, he showed hyperpyrexia, muscle rigidity, difficulty in swallowing, respiratory insufficiency, and rhabdomyolysis (creatine phosphokinase (CK), 3038 IU/l). He was diagnosed as malignant catatonia. Intravenous administration of acyclovir, high-dose methylprednisolone, antibiotics, diazepam, and dantrolene sodium was not effective. After initiating oral administration of olanzapine, his condition improved.
Department of Neurology, Shibata Hospital-Niigata Preferctural Hospital.
Hayato
H
Suzuki
Takao
T
Fukushima
Kunihiko
K
Makino
Takeo
T
Kuwabara
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000008:administration & dosage*; D002389:Catatonia / Q000188:drug therapy* / Q000209:etiology*; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D000077152:Olanzapine; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine