Catatonia in the Setting of Hyponatremia

Krueger, Anna; Shebak, Shady S.; Kavuru, Bush

doi:10.4088/pcc.15l01808

Cited by 7 publications

(11 citation statements)

References 5 publications

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“…They reported a case of hyponatraemia-induced catatonia, which was treated with clonazepam and risperidone with subsequent resolution of altered neurological state within 48–72 h ( 8 ). Kreuger and coworkers report a similar case of catatonia resulting from low sodium, which only corrected after administration of lorazepam ( 9 ). The neurological abnormalities exhibited in our patient closely resemble dyskinesia, which was observed by Nagaratnam and coworkers in 1997.…”

Section: Discussionmentioning

confidence: 99%

Delayed dyskinesia and prolonged psychosis in a patient presenting with profound hyponatraemia

John

Evans

Kalhan

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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SummaryA 65-year-old woman was admitted to the emergency unit with a 48 h history of generalised weakness and confusion. On examination, she had mild slurring of speech although there was no other focal neurological deficit. She had profound hyponatraemia (serum sodium level of 100 mmol/L) on admission with the rest of her metabolic parameters being within normal range. Subsequent investigations confirmed the diagnosis of small-cell lung cancer with paraneoplastic syndrome of inappropriate antidiuresis (SIAD). She was monitored closely in high-dependency unit with an attempt to cautiously correct her hyponatraemia to prevent sequelae associated with rapid correction. The patient developed prolonged psychosis (lasting over 2 weeks) and displayed delayed dyskinetic movements, even after a gradual increase in serum sodium levels close to 130 mmol/L. To our knowledge, delayed neurological recovery from profound hyponatraemia (without long-term neurological sequelae) has previously not been reported. This case should alert a clinician regarding the possibility of prolonged although reversible psychosis and dyskinetic movements in a patient presenting with profound symptomatic hyponatraemia.Learning points:Patients with profound hyponatraemia may develop altered sensorium, dyskinesia and psychotic behaviour.Full recovery from psychotic symptoms and dyskinesia may be delayed despite cautious correction of serum sodium levels.Careful and close monitoring of such patients can help avoid long-term neurological sequelae.

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Section: Discussionmentioning

confidence: 99%

Delayed dyskinesia and prolonged psychosis in a patient presenting with profound hyponatraemia

John

Evans

Kalhan

2017

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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“…Cariprazine is a relatively new antipsychotic agent, with a unique pharmacodynamic profile different from other typical and atypical antipsychotics, as it acts as a partial agonist at the dopamine D 2 and D 3 receptors and serotonin 5-HT1 A receptors, and as an antagonist at the 5-HT2 B receptors. 4 Its distinctiveness lies in its higher affinity for D 3 receptors, which is 10-fold higher than for D 2 receptors. Cariprazine is known to cause extrapyramidal adverse effects, most notably akathisia, especially in higher doses.…”

Section: Discussionmentioning

confidence: 99%

“…These presentations occurred in the context of catatonia and were resolved by treating catatonia with lorazepam. [2][3][4] We report a case of a patient with bipolar disorder and recurrent catatonia who was previously stabilized on lithium. However, lithium was discontinued after the emergence of polydipsia and polyuria, which initially was attributed to lithium-associated nephrogenic diabetes insipidus (NDI).…”

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confidence: 99%

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Lithium-Associated Nephrogenic Diabetes Insipidus or Catatonic Stereotypical Drinking?

Mahgoub,

Yapar,

Harbold

2024

J Clin Psychopharmacol

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“…Although there are reports of association of catatonia with hyponatremia, [2][3][4][5][6][7][8][9] there is limited data on the association of catatonia with hypernatremia. In a PubMed search, we could only find one case report documenting the association of catatonia with hypernatremia (160 mmol/L) in an 87-year-old female.…”

Section: Discussionmentioning

confidence: 99%