Catatonia y delírium: síndromes que pueden confluir en el paciente neuropsiquiátrico

Pérez-González, Andrés Felipe; Espínola-Nadurille, Mariana; Ramı́rez-Bermúdez, Jesús

doi:10.1016/j.rcp.2017.05.009

Cited by 4 publications

(5 citation statements)

References 15 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This group showed higher frequencies of neuropsychiatric features, such as delirium, visual and auditory hallucinations, and psychomotor agitation. The strong relationship between delirium and catatonia found in this study stresses the DSM‐5 definition according to which these entities are mutually exclusive; in fact, this study shows that both syndromes are related to diffuse encephalopathy, as pointed out by the relation between catatonia, delirium, and generalized dysfunction in the EEG . The catatonic syndrome observed in these patients did not remit after use of lorazepam and required in all cases the use of immunotherapy.…”

Section: Discussionsupporting

confidence: 67%

“…The strong relationship between delirium and catatonia found in this study stresses the DSM-5 definition according to which these entities are mutually exclusive; in fact, this study shows that both syndromes are related to diffuse encephalopathy, as pointed out by the relation between catatonia, delirium, and generalized dysfunction in the EEG. 18,19 The catatonic syndrome observed in these patients did not remit after use of lorazepam and required in all cases the use of immunotherapy. After immunologic maneuvers, all cases showed a complete recovery from catatonic signs.…”

Section: Discussionmentioning

confidence: 89%

“…Although DSM-5 criteria present these two disorders as mutually exclusive, there is increasing evidence that they may be present in the same patient. 18,19 The presence of fluctuations in catatonia was previously pointed out by Warren et al 10 Does the presence of catatonia in patients with ANMDARE have prognostic implications? Our sample showed that the non-catatonic group had a higher mortality, mainly related to treatment-resistant status epilepticus.…”

Section: Discussionmentioning

confidence: 93%

“…The fluctuation of catatonic symptoms was observed in 56% of our patients, and it can constitute an additional hindrance to the diagnosis of catatonia in ANMDARE, which may be related to the higher frequency of delirium in the group with catatonia (Table ). Although DSM‐5 criteria present these two disorders as mutually exclusive, there is increasing evidence that they may be present in the same patient . The presence of fluctuations in catatonia was previously pointed out by Warren et al …”

Section: Discussionmentioning

confidence: 95%

See 3 more Smart Citations

Catatonia in patients with anti‐NMDA receptor encephalitis

Espínola-Nadurille

Flores‐Rivera

Rivas‐Alonso

et al. 2019

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

Aim There is a lack of studies related to the frequency, phenomenology, and associated features of catatonic syndrome in patients with anti‐NMDA receptor encephalitis (ANMDARE). This study aimed to measure the frequency of catatonia in this condition and to delineate its particular symptoms. Methods A prospective study was done with all inpatients who fulfilled the criteria of definite ANMDARE admitted to the National Institute of Neurology and Neurosurgery of Mexico from January 2014 to September 2018. The Bush–Francis Catatonia Rating Scale and Braünig Catatonia Rating Scale were administered at admission. Results Fifty‐eight patients were included and catatonia was diagnosed in 41 of these patients (70.6%). Immobility, staring, mutism, and posturing were the most frequent catatonic signs. Catatonia was associated with delirium, hallucinations, psychomotor agitation, generalized electroencephalography dysfunction, and previous use of antipsychotics. Mortality was present in 10% of the total sample; it was associated with status epilepticus, and was less frequent in the catatonia group. After immunotherapy, all cases showed a complete recovery from catatonic signs. Conclusion This systematic assessment of catatonic syndrome shows that it is a frequent feature in patients with ANMDARE as part of a clinical pattern that includes delirium, psychomotor agitation, and hallucinations. The lack of recognition of this pattern may be a source of diagnostic and therapeutic errors, as most physicians associate catatonia with schizophrenia and affective disorders.

show abstract

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 95%

See 2 more Smart Citations

Catatonia in patients with anti‐NMDA receptor encephalitis

Espínola-Nadurille

Flores‐Rivera

Rivas‐Alonso

et al. 2019

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

show abstract

“…Viceversa, la constatación de síntomas catatónicos es frecuente en el curso del delirio [42]. Pese a ello, el DSM-5-TR [13] descarta la posibilidad de diagnosticar catatonía cuando se presenta un cuadro de delirio, consideración frecuentemente criticada por la literatura publicada [49].…”

Section: Diagnóstico Diferencialunclassified

Catatonia: A narrative review of its historical development, diagnosis, pathophysiology, and therapeutics

Arancibia,

Cavieres,

Ríos

2023

Medwave

View full text Add to dashboard Cite

Catatonia was initially a clinical presentation of certain types of schizophrenia, but basic and epidemiological evidence has demonstrated its association with multiple somatic and psychiatric conditions. We describe and discuss current clinical, etiological, pathophysiological, and therapeutic concepts regarding catatonia. We conducted a broad narrative review of articles published in MEDLINE/PubMed. The diagnosis is clinical and can be supported by additional tests, but there are psychometric instruments with different clinical focus. The most validated subtypes are inhibited and excited catatonia. It is mostly associated with somatic, neurological, affective, psychotic, and autistic spectrum disorders. Genetic factors related to oligodendrocytes have been studied in its pathophysiology. Some findings point to an imbalance in neurotransmission and density of GABA and dopamine receptors, consistent with their function in motor pathways and therapeutic response with benzodiazepines. Likewise, glutamatergic activity has been analyzed from the pathophysiological model of autoimmune encephalitis. The cortico-cortical and cortico-subcortical pathways would have a central role, including structures such as the orbitofrontal and temporal cortex, basal nuclei, and brainstem, involved in decision-making, emotion regulation, storage, planning, and motor processing. The main therapeutic lines are benzodiazepines and electroconvulsive therapy. Other interventions studied are zolpidem, antipsychotics, mood stabilizers, glutamatergic modulators, and transcranial magnetic stimulation. New neurobiological findings challenge nosological and therapeutic precepts, renewing the cycle in the conceptualization of catatonia. We highlight the affective component of the psychomotor syndrome and the role of interventions aimed at its modulation.

show abstract