The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then de...

There are a number of causes for stupor and catatonic schizophrenia is one of the important ones (Gelenberg 1976). Neurological disorders (Plum 1972; Penn et al 1972), metabolic conditions including psychotomimetic agents such as mescaline and phencyclidine, ethyl alcohol and amphetamine (Gatewood et al 1975, Jaffe 1967), and pharmacological agents include aspirin, ACTH, and neuroleptics (Weinb...

This paper sketches the early history of pituitary apoplexy, a disorder later fully described in 1950 by Brougham, Heusner and Adams. Haemorrhage or necrosis in an adenoma causes a characteristic sudden drowsiness, stupor or coma, headache and stiff neck, ocular palsy, and impaired acuity with visual field loss owing to optic nerve or chiasmal compression. The associated endocrinopathy and mana...

PURPOSE We aimed to determine which antipsychotic is most effective for the treatment of acute schizophrenia with catatonic stupor. PATIENTS AND METHODS Data were obtained from the medical records of 450 patients with the diagnosis of schizophrenia, who had received acute psychiatric inpatient treatment between January 2008 and December 2010 at our hospital. Among them, 39 patients (8.7%) met...

A patient with symptoms suggestive of neuroleptic malignant syndrome after levodopa withdrawal is described. The patient presented with persistent high fever, stupor, autonomic dysfunction, rigidity, and rhabdomyolysis. He was successfully treated with intravenous dantrolene, resumption of levodopa, and forced alkaline diuresis. Doctors should be aware of the risk of abrupt cessation of dopamin...

A woman in the care of the author 40 years ago was reported to have been sleeping for 2 days. We treated her condition as conversion hysteria. Her private psychiatrist was the renowned R. D. Laing; he was unhappy with our line of management, on the grounds of the arbitrariness of the diagnosis, the labelling of the woman with a diagnosis of hysteria and the treatment of the patient without her ...