What is Catatonia and how it is diagnosed?

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Catatonia is a neuropsychiatric syndrome wherein the cluster of psychomotor signs and symptoms effects in aberrations of movement and behavior. New standards for mood problems with catatonic capabilities, and for catatonic disorder secondary to a basic medical circumstance. Catatonia is identified as due to a medical or psychiatric circumstance, or as unspecified, in recurrent idiopathic catatonia. Mood problems together with MDD and bipolar disease are now recognized as more generally related to catatonia.

Three subtypes of catatonia are:

  •         Stuporous,
  •          Excited,
  •          Malignant.

Stuporous catatonia:

Stuporous catatonia consists of motoric immobility, staring, mutism, stress, withdrawal, and refusal to consume, along with the extra bizarre capabilities like posturing, grimacing, negativism, waxy flexibility, echo phenomena, stereotypy, verbigeration, and automatic obedience. This catatonia is also known as Catatonic withdrawal.

Excited catatonia:

Excited catatonia is characterized by way of purposeless and excessive motor activity that includes disorganized pressured speech, the flight of ideas, verbigeration, disorientation and/or confusion, and confabulation.

Malignant catatonia:

Catatonic symptoms of malignant subtype are followed with the aid of fever and dysautonomia. Malignant catatonia is related to the rise of morbidity and mortality. A clinical example of malignant catatonia is neuroleptic malignant syndrome, induced by dopamine-blockading marketers or withdrawal of a dopamine or gamma-aminobutyric acidA (GABAA) agonist.

The other variant referred to as manic delirium or delirious mania exists with features of both excited and malignant catatonia. Periodic catatonia is present both in alternating stuporous and excited forms. The prevalence of catatonia amongst psychiatric patients is between 7.6% to 38%.

Diagnosis:

Catatonia as a syndrome can also be caused from more than one etiologies and can cause clinical complications that bring about large morbidity and mortality, making rapid diagnosis and treatment a priority. Medical complications abound, and the rate of mortality for malignant catatonia in spite of higher recognition and treatment remains 9% to 10%.

A few patients suspected of being in a catatonic state may additionally have an extrapyramidal Parkinsonism. These could have a different tremor but aren’t negativistic and lack bizarre catatonic psychomotor signs and symptoms. Nonconvulsive status epileptics also can produce a catatonic-like state; electroencephalography is vital for correct diagnosis and set off management may also decrease cognitive damage. Up to 50% of instances of catatonia may be because of a host of neuro medical syndromes. These include paraneoplastic and limbic encephalitides (anti-NMDA receptor antibody encephalitis), ictal and post-ictal states, posterior reversible encephalopathy syndrome, and lupus.

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