Malignant catatonia with severe bronchorrhea and its response to electroconvulsive therapy

• Published in: Progress in neuro-psychopharmacology & biological psychiatry Vol. 30; no. 2; pp. 310 - 311
• Main Authors: Hayashi, Hiroshi, Aoshima, Toshiaki, Otani, Koichi
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01-03-2006; Elsevier
• Subjects: Adult; Biological and medical sciences; Bronchorrhea; Catatonia - complications; Catatonia - therapy; Electroconvulsive therapy; Electroconvulsive Therapy - methods; Female; Hallucinations - complications; Hallucinations - therapy; Humans; Malignant catatonia; Medical sciences; Neuroleptic Malignant Syndrome - complications; Neuroleptic Malignant Syndrome - therapy; Neuropharmacology; Pharmacology. Drug treatments; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Respiratory Insufficiency - etiology; Respiratory Insufficiency - therapy; Treatments; Electroconvulsive therapy; NMS; Malignant catatonia; MC; ECT; Bronchorrhea; Catatonia; Malignant tumor
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2005.10.003

A 21-year-old female presented excitement, auditory hallucination, monologue, and insomnia. After 1 week of risperidone administration, she showed hyperthermia, salivation, and muscle rigidity. Risperidone was discontinued, but stupor, convulsions, and respiratory distress developed. In the intensive care unit where she was transferred, catatonic symptoms such as stupor or excitement, catalepsy, and negativism were prominent. In addition, severe bronchorrhea causing respiratory failure was observed. Her catatonic symptoms, hyperthermia, and bronchorrhea resolved by ECT. After recovery, affective flattening, alogia, and avolition remained. The final diagnosis was MC associated with schizophrenia. This report suggests that MC may be complicated by severe bronchorrhea, but this condition responds to ECT.