Lethal Catatonia Syndrome 3례

Three Cases of Lethal Catatonia Syndrome

Lethal catatonia syndrome, first reported by Calmeil and first named by Stauder, is a lifethreatening neuropsychiatric disorder characterized by mounting fever, extreme hyperactivity and stuporous exhaustion. While lethal catatonia is more commonly recognized as an outgrowth of a functional psychiatric disorders, it may also develop in association with a medical disorders directly or indirectly affecting the CNS. While the pathogenesis of lethal catatonia is unclear, disordered functioning within the diencephalon and other brain areas possibly involving alterations in central dopaminergic transmission. Neuroleptic malignant syndrome may be considered a neuroleptic-induced iatrogenic form of lethal catatonia. In lethal catatonia of functional orgin, neuroleptics appear inadequate in treatment and may aggravate or complicate episodes of the disorder. Although some authors argue that steroids are useful, ECT appears to be the preferred treatment in functional origin. In organic origin, treatment should be directed at the underlying disorder and ECT may help relieve symptoms. Familiarity with the clinical features and varied etiologies is essential for prognosis and effective management. The authors presented three cases showing lethal catatonia syndrome’s clinical feature with a brief review.