[Regional cerebral blood flow-SPECT "OFF-ON": a case report of catatonia].
We report the case of a patient with a long history of dysthymia and major depressive episodes requiring repeated hospitalization. We describe the most recent episode, associated with catatonia symptomatology and features suggestive of cognitive impairment. The absence of a clear initial psychopharmacological response alongside the clinical severity made the patient a potential candidate for electroconvulsive therapy (ECT). A regional cerebral blood flow SPECT (SPECT-rCBF), performed to rule out concomitant Alzheimer disease (AD), revealed a markedly decreased neocortical uptake, with no definitive pattern of concomitant primary cognitive impairment. Because a gradual clinical improvement was observed in the patient, with evidence of enhanced cerebral reperfusion in a second SPECT-rCBF study at two weeks after admission, the application of ECT was discounted and an expectant attitude was adopted.
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España. Electronic address: manuel.moreno.caballero.samn@gmail.com.
M
M
Moreno Caballero
Servicio de Psiquiatría, Hospital Universitario Virgen de las Nieves, Granada, España.
N
N
Corchos González
Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
I
I
De Antonio Rubio
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España.
M
M
Gómez-Río
Servicio de Psiquiatría, Hospital Universitario Virgen de las Nieves, Granada, España.
J F
JF
Guerrero Velázquez
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España.
A
A
Rodríguez Fernández
Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, España.
J M
JM
Llamas Elvira
D000368:Aged; D002389:Catatonia / Q000209:etiology / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D019965:Neurocognitive Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon
Catatonia; Cerebral blood flow SPECT; Demencia; Dementia; Depressive pseudodementia; Pseudodemencia depresiva; SPECT de perfusión cerebral