Catatonia: A Rare Presenting Symptom of Wilson’s Disease

Nayak, Raghavendra B; Shetageri, Veda N.; Bhogale, Govind S; Patil, Nanasaheb M; Chate, Sameeran S; Chattopadhyay, Sunny

doi:10.1176/appi.neuropsych.11070169

Cited by 10 publications

(4 citation statements)

References 6 publications

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“…Seven to 45 % of catatonias are “organic catatonias” that is, catatonia secondary to a general medical condition [ 1 – 4 ]. Among them, some cases of catatonia associated with autoimmune diseases have been described in systemic lupus erythematosus, anti-NMDAR (N-methyl-d-aspartate receptor) encephalitis [ 5 – 8 ], paraneoplasic syndrome [ 7 , 9 , 10 ], PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder) [ 11 ] and in other rare syndromes like Wilson disease [ 12 ]. First line recommended treatementr in catatonia are benzodiazepine and ECT [ 13 ] but, in case of SLE and anti-NMDAR encephalitis in adults, etiological treatment, respectively plasma exchange and immunoglobulin perfusion associated with corticosteroid, is an efficient option avoiding using ECT and psychotropic drugs [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Attempted infanticide and suicide inaugurating catatonia associated with Hashimoto’s encephalopathy: a case report

et al. 2016

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BackgroundCatatonia is a neuropsychiatric syndrome with motor and behavioural symptoms. Though usually occuring in patients with schizophrenia and mood disorders, this syndrome may also be associated with neurological diseases or general medical conditions. Few cases of catatonia associated with autoimmune disorders have been described.Case presentationHere, we report the case of a 27-year-old woman diagnosed with Hashimoto’s encephalitis (HE) who attempted suicide and infanticide by defenestration. As she presented risk factors for postpartum psychosis, she was treated principally with antipsychotics. Despite adequate treatment for psychosis, symptoms worsened and she developed catatonia. Complementary investigations showed elevated titres of anti-thyroglobulin and anti-thyroperoxidase antibodies (200 and 10 times, respectively, as compared to normal levels) and electroencephalography were suggestive of encephalopathy. In the presence of an otherwise unexplained neuropsychiatric condition, HE was suspected and oral prednisolone was introduced. Psychiatric symptoms improved dramatically within 72 h and the patient was still free of any symptom 3 years later.ConclusionCatatonia of organic aetiology should always be considered before a psychiatric aetiology especially in case of clinical worsening in spite of adequate psychotropic treatment. To our knowledge, this is the first description of catatonia associated with HE.

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Section: Introductionmentioning

confidence: 99%

Attempted infanticide and suicide inaugurating catatonia associated with Hashimoto’s encephalopathy: a case report

et al. 2016

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“…Nine months after starting chelation therapy, the patient scored 10 on the BFCRS and 2 on the Katz scale. In three previously described cases, chelation had mixed 4,8,9…”

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confidence: 87%

Catatonia – not only a schizophrenia subtype: a case report of Wilson’s disease

Braga

Pina

Cantilino³

et al. 2019

Braz. J. Psychiatry

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“…Hallucinations (mostly auditory) have been rarely reported and are typically associated with delusion of reference or persecution (Bidaki et al, 2012;Kontaxakis et al, 1988;Matarazzo, 2002). WD presentation with psychotic manifestation also encompassed the rare syndrome of catatonia in youth (Nayak et al, 2012;Sahoo, Avasthi, Sahoo, Modi, & Biswas, 2010) and even in paediatric age (Davis & Borde, 1993). Despite the interest on the association between WD and schizophrenia-like disorders, the occurrence of WD with bipolar disorder (BD) spectrum symptoms at its onset (with manic/hypomanic episodes, over-activity, irritability, aggressive behaviour, disinhibition, suicide attempts) has been most frequently described in case reports (Aravind, Krishnaram, Neethiarau, & Srinivasan, 2009;Chand & Murthy, 2006;Keller, Torta, Lagget, Crasto, & Bergamasco, 1999;Machado et al, 2008;McDonnell & Esmonde, 1999;M€ uller, 1999;Nazariah, Aisah, Anita, Yeoh, & Ng, 2011;Vale, Caramelli, & Teixeira, 2011).…”

Section: Wd Presenting As a Psychiatric Disordermentioning

confidence: 99%

“…Some authors reported a good response of manic symptoms with atypical antipsychotics, such as olanzapine (Litwin, Dzie_ zyc, Karli nski, Szafra nski, & Członkowska, 2016), and quetiapine (Kulaksizoglu & Polat, 2003;Zimbrean & Schilsky, 2015). Traditional neuroleptics, such as haloperidol, could determine the occurrence of extrapyramidal symptoms in individuals both with BD (Varghese et al, 2008) and with psychotic symptoms in WD (Nayak et al, 2012). Risperidone carries the same risk (Vaishnav & Gandhi, 2013).…”

Section: The Use Of Psychotropic Medications For Psychiatric Symptomsmentioning

confidence: 99%

Psychiatric comorbidity in Wilson’s disease

Mura

Zimbrean

Demelia

et al. 2017

International Review of Psychiatry

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Wilson's disease (WD) is a relatively rare autosomal recessive inherited disorder causing copper accumulation in different organs, mainly the liver and brain. Psychiatric disturbances represent a diagnostic and therapeutic issue in WD. A search for relevant articles was carried out on PubMed/Medline, Scopus, and Google Scholar, for papers focused on psychiatric disorders in WD published between 1985-2016. Ninety-two articles were included in this review, showing the findings from 35 observational and case-control studies and 57 case reports. This study discussed the findings on the prevalence of psychiatric symptoms in WD, their impact on the life of those diagnosed, and the efficacy of available treatments on the psychiatric outcomes of WD. Psychiatric disorders are confirmed frequent in WD, with a high prevalence of mood disorders, and contribute to worse Quality-of-Life and psychosocial outcomes. Because specific therapies for WD lead to a good life expectancy, adherence to medicaments and clinical monitoring should be warranted by a multidisciplinary approach, including a hepathologic, neurologic, and psychiatric careful evaluation and education of those affected and their relatives.

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Catatonia: A Rare Presenting Symptom of Wilson’s Disease

Cited by 10 publications

References 6 publications

Attempted infanticide and suicide inaugurating catatonia associated with Hashimoto’s encephalopathy: a case report

Attempted infanticide and suicide inaugurating catatonia associated with Hashimoto’s encephalopathy: a case report

Catatonia – not only a schizophrenia subtype: a case report of Wilson’s disease

Psychiatric comorbidity in Wilson’s disease

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