Chronic catatonia with obsessive compulsive disorder symptoms treated with lorazepam, memantine, aripiprazole, fluvoxamine and neurosurgery.
Catatonia is a syndrome with protean manifestations and multiple aetiologies. In this report, the authors describe the case of a young woman who presented for care after a 13-year period of catatonia-like symptoms, including mutism, refusal to eat and persistent neck flexion. Medical management included placement of a percutaneous endoscopic gastric tube for nutritional support. A thorough medical investigation later revealed the presence of a cervical spine haemangioma that was treated surgically, with improvement in neck posturing. Psychopharmacological treatment included lorazepam, aripiprazole and memantine. Addition of fluvoxamine to target obsessive compulsive disorder (OCD)-like symptoms resulted in clinical improvement, suggesting OCD as a possible cause of this patient's chronic catatonic state.
Department of Child Psychiatry, Columbia and Cornell, New York, New York, USA.
Yuki
Y
Mukai
Aimee
A
Two
Michel
M
Jean-Baptiste
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D000068180:Aripiprazole; D002389:Catatonia / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use*; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D008559:Memantine / Q000627:therapeutic use*; D019635:Neurosurgical Procedures; D009771:Obsessive-Compulsive Disorder / Q000150:complications* / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use*; D015363:Quinolones / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D000068180:Aripiprazole; D015259:Dopamine Agents; D016666:Fluvoxamine; D018757:GABA Modulators; D008140:Lorazepam; D008559:Memantine; D010879:Piperazines; D015363:Quinolones; D017367:Selective Serotonin Reuptake Inhibitors