Catatonia

Catatonia
Medical Pathology of Psychiatry
Catatonia is a state of apparent unresponsiveness to external stimuli in a person who is apparently awake. The condition is difficult todifferentiate from diffuse encephalopathy, nonconvulsive status epilepticus, neuroleptic malignant syndrome, acute psychosis, somatization disorder, conversion disorder, factitious disorder, malingering, andpsychogenic movement disorders. (See DDx, Presentation, and Workup.)
Psychomotor manifestations of catatonia  analyzed by latent class techniques have been divided into 4 classes, as follows
*Automatic
* Repetitive/echo
* Withdrawal
* Agitated/resistive

Catatonia is not a diagnosis. Rather, catatonia is a descriptive term for a presentation observed in a wide variety ofdisorders. While there exists a vast differential diagnosis for catatonia, the identification of treatable causes, such as nonconvulsive status epilepticus, is crucial to the administration of the neededinterventions. When faced with a patient with catatonia, the clinician must first rule out treatable causes. (See Etiology, Presentation, Workup, Treatment, and Medication.)-------------------------------------------------
Complications
The following complications are associated with catatonia (see Prognosis, Treatment, and Medication):
* Trauma - During an excited state, patients withcatatonia may cause serious, even fatal, injuries to themselves and others; they may cause marked destruction of property
* Refusal to eat - Patients with catatonia may refuse to eat; death may resultunless parenteral nutrition and fluids are administered on an involuntary basis
* Autonomic instability - Patients with catatonia may experience autonomic instability manifested by hyperthermia,hypertension, and tachycardia; medical intervention is required.
* Neuroleptic malignant syndrome - If this condition occurs, medical consultation is appropriate.
* Pulmonary embolism - Risk of...