Failure of PET Scan: A Case of Psychiatric Catatonia Mistaken for Encephalitis

Abstract

Catatonia is a neuropsychiatric syndrome that can mimic or accompany a variety of psychiatric and medical conditions. An etiology is often elusive, especially when patients present with a history with multiple confounding features. Workup for rapidly progressive illnesses such as N-methyl-D-aspartate receptor (NMDAR) encephalitis can involve multiple laboratory tests and brain imaging, such as [ 18 F]fluorodeoxyglucosepositron emission tomography (FDG-PET). However, some catatonic behaviors may confound FDG-PET results and delay appropriate treatment. This case highlights the diagnostic and therapeutic challenges in catatonia and the potential danger of overreliance on imaging before proceeding with symptomatic treatment.

ECT Utilization in the Treatment of Catatonic Patients in the United States

“…Electroconvulsive therapy is efficacious in N-methyl d-aspartate encephalitis associated with catatonia. 10 Electroconvulsive therapy is beneficial in autism spectrum disorders patients aged 8 to 26 years with catatonic symptoms. 11 The factors influencing ECT utilization for catatonia treatment remain unknown.…”

“…Electroconvulsive therapy has 80% to 100% effectiveness 2 for the treatment of catatonia. Electroconvulsive therapy is efficacious in N-methyl d-aspartate encephalitis associated with catatonia 10 . Electroconvulsive therapy is beneficial in autism spectrum disorders patients aged 8 to 26 years with catatonic symptoms 11 …”