A Tale of Two Catatonic States
نویسندگان
چکیده
Aims Catatonia is a psychomotor state characterised by multitude of clinical signs such as abnormal movements, mutism and withdrawal. This condition usually associated with medical psychiatric aetiologies potential being life-threatening. It managed benzodiazepines, the commonest lorazepam. In this piece work, we would like to focus on principles care that should be considered whilst managing presentations. Methods Case 1- 71, male diagnosis paranoid schizophrenia was brought Emergency department (ED) via ambulance, he found ‘unresponsive’ in home. On arrival, alert GCS 11/15 observed mute, ‘gesturing’ making purposeless movements. Following our assessment, administered 0.5mg lorazepam resuscitation bay. Subsequently, started sounds given another dose He then vocalised his thoughts established mental had relapsed harbouring delusions. 2- 18, no prior history ED parents following 3 day not ‘responding’, eating or drinking insomnia. alert, pacing room, however remained mute. 2 mg bay initial 1mg showed minimal response. later review, smiling, conversant co-operative, thus allowing assessment unmasked which suggestive first episode psychosis. few hours, both patients reverted back their original catatonic state. Results Lorazepam can used diagnostic measure conjunction therapeutic intervention. A positive Challenge test confirms catatonia. must borne mind only temporary holding assess patient's they need further monitoring interventions treat underlying cause. Conclusion safely an technique for presenting acute conducted closely monitored environments namely, bay, HDU ITU appropriate support ongoing liaison psychiatry team. Treating teams mindful various patient characteristics including age, past treatment inform adjustments necessary. Disclaimer: Unable obtain consent due unstable but ensured identifiable data included.
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ژورنال
عنوان ژورنال: British Journal of Psychiatry Open
سال: 2023
ISSN: ['2056-4724']
DOI: https://doi.org/10.1192/bjo.2023.337