A Case Report of Intramuscular Lorazepam in Catatonia of a Parkinson's Disease Patient after Deep Brain Stimulation.

In Diagnostic and Statistical Manual (DSM)-5, catatonia is defined by the presence of three or more of 12 psychomotor disturbances, which may be associated with mental disorder or medical condition (Tandon et al. 2013). Catatonia could be treated with benzodiazepine (BZD) or electroconvulsive therapy (ECT) (Lin & Huang 2013, Huang et al. 2013, Raveendranathan et al. 2012). Parkinson's disease (PD) is characterized by motor disturbances that manifests as tremor, rigidity, and bradykinesia. Deep brain stimulation (DBS) is a surgical procedure that implants an electrical pacemaker to deep brain structures, such as subthalamic nucleus and the globus pallidus internus. DBS has been found to be effective in managing motor problem for refractory PD (Lukins et al. 2014). There had been only few reports regarding catatonia in patient with PD (Poyraz et al. 2016) or in patients treated with DBS (Coffey et al. 2010, Quinn et al. 2014). Treatment responses of BZD in those reports were inconsistent. Here, we present a female patient with PD treated with deep brain stimulation (DBS) for 18 months who suddenly developed catatonia during hospitalization. Literature regarding catatonia associated with PD and DBS was reviewed.