Malignant catatonia-induced respiratory failure with response to ECT
Autor: | Michael Fuller, Terrance Early, Beth K. Boyarsky |
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Rok vydání: | 1999 |
Předmět: |
Male
Psychosis Catatonia business.industry medicine.medical_treatment Neuroscience (miscellaneous) Lorazepam Middle Aged medicine.disease Dantrolene Bromocriptine Neuroleptic malignant syndrome Psychiatry and Mental health Electroconvulsive therapy Treatment Outcome Respiratory failure Psychotic Disorders Anesthesia medicine Humans business Electroconvulsive Therapy Respiratory Insufficiency medicine.drug |
Zdroj: | The journal of ECT. 15(3) |
ISSN: | 1095-0680 |
Popis: | A 47-year-old acutely psychotic schizophrenic man was diagnosed with malignant catatonia. Because of a history of neuroleptic malignant syndrome (NMS), traditional neuroleptics were avoided, and the patient had been treated with reserpine for a period of 10 years. Symptomatically, severe agitation alternated with severe retardation. The syndrome progressed, despite early termination of any neuroleptic medications, to marked catatonic rigidity and dehydration. Worsening was associated with transfer to a medical intensive care unit, intubation, and subsequently a tracheostomy. Dantrolene and bromocriptine were unhelpful. Lorazepam produced muscular relaxation and resulting decreases in creatine phosphokinase levels but elicited no other improvement. Eleven bilateral electroconvulsive treatments, however, resolved the respiratory impairment and catatonia and improved the psychosis. This report highlights the efficacy of ECT in lethal catatonia despite respiratory impairment and tracheostomy. |
Databáze: | OpenAIRE |
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