Catatonic coma with profound bradycardia.

Catatonia may be monosymptomatic at presentation, with stupor or coma as the cardinal and only manifestation. A case of catatonic coma with profound bradycardia is presented to help clinicians recognize this entity and include catatonia in the differential diagnosis of coma as a rare etiology after other more common causes of coma have been excluded. Cases of catatonic coma are nevertheless important to identify because treatment with intravenous benzodiazepines is simple and highly effective. The authors argue that the descriptive term "catatonic coma" is preferable over terms implying psychogenesis, such as "psychogenic" or "hysterical" coma; for catatonia, the authors have a specific treatment, in the form of benzodiazepines; for "psychogenesis," there is none.

[1]  J. Posner Comprar Plum and Posner´s Diagnosis of Stupor and Coma | Jerome B. Posner | 9780195321319 | Oxford University Press , 2007 .

[2]  B. Carroll,et al.  Memantine and catatonic schizophrenia. , 2005, The American journal of psychiatry.

[3]  J. Ananth,et al.  Neuroleptic malignant syndrome and atypical antipsychotic drugs. , 2004, The Journal of clinical psychiatry.

[4]  W. White,et al.  Psychogenic Coma: Case Report , 2003, International journal of psychiatry in medicine.

[5]  M. Fink,et al.  Catatonia in psychiatric classification: a home of its own. , 2003, The American journal of psychiatry.

[6]  A. Kogoj,et al.  Olanzapine induced neuroleptic malignant syndrome—a case review , 2003, Human psychopharmacology.

[7]  H. Vogt,et al.  Dissoziativer Stupor als Ursache für postoperative Bewusstlosigkeit , 2003, Der Anaesthesist.

[8]  K. Bottum,et al.  Suppression of catatonia-like signs by lorazepam in nonconvulsive status epilepticus without seizure termination. , 2002, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[9]  Edwin Harari,et al.  Reply to Kaplan , 2000 .

[10]  S. Carley,et al.  An unusual case of hysterical postoperative coma , 1999, Anaesthesia.

[11]  T. Dexter Death in the dental chair , 1999, Anaesthesia.

[12]  T. Landis,et al.  Olanzapine-induced neuroleptic malignant syndrome. , 1999, Archives of general psychiatry.

[13]  G. Northoff,et al.  Glutamatergic dysfunction in catatonia? Successful treatment of three acute akinetic catatonic patients with the NMDA antagonist amantadine. , 1997, Journal of neurology, neurosurgery, and psychiatry.

[14]  P. J. Alexander,et al.  Limited utility of ICD‐10 and DSM‐IV classification of dissociative and conversion disorders in India , 1997, Acta psychiatrica Scandinavica.

[15]  J. Caviness,et al.  Psychogenic coma after use of general anesthesia for ethmoidectomy. , 1996, Mayo Clinic proceedings.

[16]  R. Albrecht,et al.  Factitious disorder as a cause of failure to awaken after general anesthesia. , 1995, Anesthesiology.

[17]  B. Carroll,et al.  Clinical Electroencephalograms in Patients with Catatonic Disorders , 1995, Clinical EEG.

[18]  L. Cocito,et al.  Epileptic seizures in patients with acute catatonic syndrome. , 1994, Journal of neurology, neurosurgery, and psychiatry.

[19]  A. Klimke,et al.  Sudden death after intravenous application of lorazepam in a patient treated with clozapine. , 1994, The American journal of psychiatry.

[20]  L. P. Ormerod,et al.  Recurrent Sinus Arrest in Association with Neuroleptic Malignant Syndrome , 1994, British Journal of Psychiatry.

[21]  V. Benegal,et al.  Is stupor by itself a catatonic symptom? , 1992, Psychopathology.

[22]  G. Fricchione Neuroleptic catatonia and its relationship to psychogenic catatonia , 1985, Biological Psychiatry.

[23]  J. Lohr,et al.  Diazepam for catatonia. , 1984, The American journal of psychiatry.

[24]  G. Fricchione,et al.  Intravenous Lorazepam in Neuroleptic‐Indueed Catatonia , 1983, Journal of clinical psychopharmacology.

[25]  D. Shraberg,et al.  Coma vigil masquerading as psychiatric illness. , 1982, The Journal of clinical psychiatry.

[26]  C. Poser,et al.  The Diagnosis of Stupor and Coma , 1981 .

[27]  S. Takahashi,et al.  PARADOXICAL BRADYCARDIA DURING REM SLEEP IN PERIODIC CATATONIA , 1973, Acta psychiatrica Scandinavica.

[28]  F. Plum,et al.  The diagnosis of stupor and coma. , 1972, Contemporary neurology series.