title: Agitation after minor trauma: combativeness as a cardinal catatonic feature.
abstract: Catatonia is a syndrome of motor dysregulation, usually associated with psychiatric, neurological, systemic and drug-related diseases. Retarded and excited types exist, both of which often go unrecognised in clinical practice. We describe a 64-year-old woman who gradually developed insomnia, started communicating less, complained of feeling restless and ended up injuring relatives. Initiation of symptoms followed a fibula fracture. The patient was diagnosed with excited-type catatonia with prominent combativeness because of minor trauma and rapidly recovered after lorazepam treatment instatement. Our case demonstrates that catatonia can follow minor traumatic injury and how excited-type catatonic features may go unrecognised in general practitioner and specialist settings. Moreover, we show that catatonia may be recurrent, necessitating long-term treatment and very gradual lorazepam tapering.
authors.affiliation: Department of Psychiatry, ZNA Hospital Stuivenberg, Antwerp, Belgium.
authors.forename: Jurjen Justin
authors.initials: JJ
authors.lastname: Luykx
authors.forename: Elmar Hendrik
authors.initials: EH
authors.lastname: Post
authors.forename: Maaike
authors.initials: M
authors.lastname: van der Erf
authors.forename: Jan
authors.initials: J
authors.lastname: Van Hecke
mesh_terms: D002389:Catatonia / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008140:Lorazepam / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011595:Psychomotor Agitation / Q000188:drug therapy / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed; D016482:Urinalysis; D014947:Wounds and Injuries / Q000503:physiopathology*
chemical_list: D006993:Hypnotics and Sedatives; D008140:Lorazepam