Case Report

Electroconvulsive Therapy for Malignant Catatonia in Adolescence

Authors: Dirk M. Dhossche MD, PhD, Shashidhar M. Shettar MD, Tarun Kumar MD, Laura Burt RN

Abstract

Abstract:Malignant catatonia is a severe form of catatonia which is acute in onset, and is systemically devastating, as it is associated with fever and autonomic instability. Although rarely described in children and adolescents, malignant catatonia should feature prominently in the differential diagnosis of acute pediatric encephalopathies, as it is a treatable syndrome. The case of a 17-year-old adolescent with sickle cell anemia is presented. The patient developed malignant catatonia and responded dramatically to electroconvulsive therapy.

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References

References1. Fink M, Taylor MA. Catatonia: A Clinician’s Guide to Diagnosis and Treatment. Cambridge, UK, Cambridge University Press, 2003.FinkM]]TaylorMACatatonia: A Clinician’s Guide to Diagnosis and Treatment.Cambridge, UKCambridge University Press20032. Kahlbaum K. Die Katatonie oder das Spannungsirresein. Berlin, Verlag August Hirshwald, 1874.KahlbaumKDie Katatonie oder das Spannungsirresein.BerlinVerlag August Hirshwald18743. Gelenberg AJ. The catatonic syndrome. Lancet 1976;1:1339–1341.GelenbergAJThe catatonic syndrome.Lancet197611339-13414. Dhossche D, Bouman N. Catatonia in children and adolescents (letter). J Am Acad Child Adolesc Psychiatry 1997;36:870–871.DhosscheD]]BoumanNCatatonia in children and adolescents (letter).J Am Acad Child Adolesc Psychiatry199736870-8715. Dhossche DM, Bouman NH. Catatonia in an adolescent with Prader-Willi Syndrome. Ann Clin Psychiatry 1997;9:247–253.DhosscheDM]]BoumanNHCatatonia in an adolescent with Prader-Willi Syndrome.Ann Clin Psychiatry19979247-2536. Dhossche D, Wing L, Ohta M, et al (eds). Catatonia in Autism Spectrum Disorders. International Review of Neurobiology. San Diego, CA, and London, UK, Elsevier Academic Press, 2006, vol 72.7. Cizadlo BC, Wheaton A. Case study: ECT treatment of a young girl with catatonia. J Am Acad Child Adolesc Psychiatry 1995;34:332–335.CizadloBC]]WheatonACase study: ECT treatment of a young girl with catatonia.J Am Acad Child Adolesc Psychiatry199534332-3358. Slooter AJ, Braun KP, Balk FJ, et al. Electroconvulsive therapy of malignant catatonia in childhood. Pediatr Neurol 2005;32:190–192.SlooterAJ]]BraunKP]]BalkFJ&etal;Electroconvulsive therapy of malignant catatonia in childhood.Pediatr Neurol200532190-1929. Lee A, Glick DB, Dinwiddie SH. Electroconvulsive therapy in a pediatric patient with malignant catatonia and paraneoplastic limbic encephalitis. J ECT 2006;22:267–270.LeeA]]GlickDB]]DinwiddieSHElectroconvulsive therapy in a pediatric patient with malignant catatonia and paraneoplastic limbic encephalitis.J ECT200622267-27010. Chung A, Varghese J. Treatment of catatonia with electroconvulsive therapy in an 11-year-old girl. Aust N Z J Psychiatry 2008;42:251–253.ChungA]]VargheseJTreatment of catatonia with electroconvulsive therapy in an 11-year-old girl.Aust N Z J Psychiatry200842251-25311. Stauder KH. Die tödliche katatonie. Arch Psychiatr Nervenkrank 1934;102:614–634.StauderKHDie tödliche katatonie.Arch Psychiatr Nervenkrank1934102614-63412. Rey J, Walter G. Half a century of ECT use in young people. Am J Psychiatry 1997;154:595–602.ReyJ]]WalterGHalf a century of ECT use in young people.Am J Psychiatry1997154595-60213. Abrams R. Electroconvulsive Therapy. New York, Oxford University Press, 2002, ed 4.14. Viguera A, Welch C, Bigatello L, et al. Hemodynamic responses to electroconvulsive therapy in a hypertensive patient with end-stage pulmonary fibrosis. Anesth Analg 1998;87:737–741.VigueraA]]WelchC]]BigatelloL&etal;Hemodynamic responses to electroconvulsive therapy in a hypertensive patient with end-stage pulmonary fibrosis.Anesth Analg199887737-74115. LaGrone D. ECT in secondary mania, pregnancy, and sickle cell anemia. Convuls Ther 1990;6:176–180.LaGroneDECT in secondary mania, pregnancy, and sickle cell anemia.Convuls Ther19906176-180