Paliperidone is an atypical antipsychotic medication commonly used to treat schizophrenia, schizoaffective disorder, and bipolar disorder. It is a metabolite of risperidone and has a similar mechanism of action, primarily blocking dopamine 2 receptors (D2 receptors) in the brain. Paliperidone has various adverse effects, including extrapyramidal symptoms, weight gain, and metabolic disturbances. Catatonia is rare but severe side effects can occur in the context of an underlying psychiatric, neurologic, or general medical condition. Paradoxically, antipsychotics for treating schizophrenia or bipolar spectrum disorders can precipitate or worsen catatonic symptoms. The report suggests that 17-19% of all cases diagnosed as catatonia due to other medical conditions are medication-induced. Catatonia is a neuropsychiatric syndrome that presents as a cluster of psychomotor signs and symptoms resulting in movement and behavior aberrations. Various symptoms, including mutism, stupor, rigidity, and abnormal movements, characterize catatonia. Catatonia is a potentially life-threatening condition requiring prompt recognition and management. Here, we present a case of a patient with catatonia associated with long-acting injectable paliperidone intramuscular therapy in a patient with schizophrenia.
Background/Aims The changes in body weight, body shape and hormones of pregnant women alter the posture and gait pattern of these individuals compared to non-pregnant women. The purpose of this study was to determine the effect of pregnancy on selected gait parameters by evaluating footprints at the second and third trimesters of pregnancy and comparing with apparently healthy, non-pregnant women. Methods A total of 40 consenting women (20 pregnant and 20 non-pregnant age-matched women) aged 22–35 years old (mean 28.25±0.68 years) participated in this study. Footprints were obtained from each participant and selected gait parameters were computed from the footprints. Paired t-tests and independent t-tests were used to compare the variables at P<0.05. Results There was a significant difference in the gait parameters measured between the pregnant and non-pregnant women: gait velocity (P=0.001), cadence (P=0.001), right foot angle (P=0.001), left foot angle (P=0.002), base of support (P=0.001), right step length (P=0.001), left step length (P=0.001). However, there was no significant difference in the gait parameters measured between the pregnant women in their second and third trimesters. Conclusions Pregnancy is associated with significant changes in most gait variables compared to non-pregnant women, although no significant change was observed between the second and third trimesters of pregnancy. The inclusion of gait training during antenatal care may help reduce the effect on the musculoskeletal system.
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