Relapsing–remitting psychosis with malignant catatonia: a multidisciplinary challenge

Gerra, Maria Lidia; Mutti, Carlotta; Luviè, Lorenzo; Daniel, Benyamin Daniel; Florindo, Irene; Picetti, Edoardo; Parrino, Liborio; Marchesi, Carlo; Zinno, Lucia

doi:10.1080/13554794.2022.2032185

Cited by 1 publication

(2 citation statements)

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“…Otro subtipo identificado es la catatonía maligna, originalmente denominada "catatonía letal" [31], diferenciada por la inestabilidad autonómica y hemodinámica que involucra sintomatología como fiebre, taquicardia, palpitaciones, alteración de consciencia, cambios en la presión arterial, diaforesis y taquipnea [32]. Presenta una evolución rápida y un posible desenlace fatal, por lo que demanda alto índice de sospecha y tratamiento inmediato [33].…”

Section: Clínica Y Diagnósticounclassified

“…Simultáneamente, deben prevenirse y tratarse las complicaciones vinculadas (por inmovilidad, rechazo a la hidratación e ingesta alimentaria y disfunción autonómica) [19], así como la sintomatología catatónica propiamente tal. Aquellos pacientes que presentan inestabilidad autonómica y hemodinámica, constituyen un grupo de alto riesgo para complicaciones y mortalidad, que requiere tratamiento inmediato [33]. Entre las complicaciones más frecuentes se encuentran la trombosis venosa profunda, tromboembolía pulmonar, aspiración, rabdomiolisis con potencial daño renal, úlceras por presión y contracturas musculares [1,11].…”

Section: Aspectos Generalesunclassified

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

Arancibia,

Cavieres,

Ríos

2023

Medwave

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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.

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Section: Clínica Y Diagnósticounclassified

Section: Aspectos Generalesunclassified