Electroconvulsive Therapy for Catatonia in Neuropsychiatric Systemic Lupus Erythematosus

Abstract

Neuropsychiatric systemic lupus erythematosus encompasses neurological syndromes of the central, peripheral, and autonomic nervous system and a variety of psychiatric syndromes. Neuropsychiatric systemic lupus erythematosus presenting as catatonia is uncommon, and treatment of this condition is not well defined. Here we describe a case of neuropsychiatric systemic lupus erythematosus with catatonia and our treatment approach focusing on electroconvulsive therapy in conjunction with cyclophosphamide. We also discuss the pathophysiological underpinnings of the condition and the basis for treatment.

Catatonia in systemic lupus erythematosus: a case report and review of literature

“…After a thorough PubMed search in January 2013 and after checking all of the cross references, we could find only 22 cases of catatonic symptoms in SLE reported in the literature. Details of 19 such cases [4][5][6][7][8][9][10][11][12][13][14][15] are shown in Table 1. We were unsuccessful in obtaining details of three case reports.…”

Electroconvulsive Therapy for Severe Neuropsychiatric Lupus With Psychosis

“…18 ECT has also been reported to be of use in SLE patients with catatonia, 8,19Y21 including hyperkinetic and akinetic mutism. 22 More recently in 2010, Fam et al 10 reported the treatment of a case of NPSLE with catatonia with ECT in conjunction with cyclophosphamide.…”

Electroconvulsive therapy as a treatment for refractory neuropsychiatric lupus with catatonia: three case studies and literature review

“…reported an experience with ECT in a patient with severe psychosis, mania, and catatonia, also with excellent results. 9 Subsequently, other cases of successful use of ECT as an adjunct therapy in severe neuropsychiatric lupus were published 10–12 that included the use of ECT in juvenile SLE presenting with catatonia and severe depression. 2,13–15 Table 1 provides a detailed review of all cases reported in the literature.…”