Differential Diagnosis of Psychotic Disorder with High Creatine Kinase and Subfebrile Fever : A Case Report

Catatonia is a syndrome, comprised of symptoms such as excessive motor activity, extreme negativism, motor immobility, and stereotyped movements. The malignant form of catatonia (MC) is considered to be a fatal and rapidly progressive subtype. It is a rare condition that pres¬ents subtle signs and symptoms and different etiologies, and is therefore underdiagnosed. Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics and characterized by a distinctive clinical syndrome of mental status change, rigidity, fever, and dysautonomia. MC resembles NMS in many ways but was described long before the introduction of neuroleptics. Cotard and capgras delusions may be associated with MC and NMS. The present case report demonstrates the difficulty of correctly diagnosing MC, NMS and emphasizes the importance of symptom chronology while going to take a diagnosis.