The Curious Case of a Catatonic Patient

The Curious Case of a Violently Ill Woman

“…These last diminished under ECT. As in our first Curious Case, 16 the energy level required to elicit a seizure at ECT was not changed by the addition of an anti-epileptic. In spite of all our efforts, the patient did not attain to anything near her premorbid levels of functioning but remained withdrawn, aloof, and with multiple negative symptoms.…”

“…We received questions from A.S. Bassett, MD, from Toronto University, as to whether we had considered 16 : (1) Parkinson disease (very early onset), (2) 22q11.2 deletion syndrome, and (3) hypocalcemia or other metabolic condition or Parkinson disease, though she had not seen mention of any particular features in this regard. Also, (4) was there any helpful family history for this patient?…”

Antiepileptics in Electroconvulsive Therapy

“…In a retrospective chart review on a different group of patients, they found that all of their patients receiving ECT and BZDs experienced resolution of catatonia symptoms (n = 57) 27 . Similar findings have been replicated in single-patient case reports 18,28–30 and a case series where 3 of 4 patients experienced rapid resolution of neuroleptic malignant syndrome symptoms when receiving ECT and BZDs 21 . An additional case series (n = 4) reviewed patients who were taken off their BZDs only to become catatonic during ECT; 2 of the patients required BZDs during ECT, although 1 of them was ultimately tapered 31 …”