Catatonia. Kristen Shirey, M.D. Duke University Hospital Internal Medicine and Psychiatry. Catatonia. Common Signs are easily identifiable Many faces NMS is a form of malignant catatonia Differential diagnosis Syndrome of motor dysregulation Good-prognosis condition Easy to treat.
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Kristen Shirey, M.D.
Duke University Hospital
Internal Medicine and Psychiatry
2 out of following 5 criteria:
Immobility, mutism or stupor for at least 1 hour + one of the following:Catalepsy, automatic obedience, posturing, observed or elicited at least twice
In the absence of immobility, mutism or stupor, need to observe or elicit at least twice at least two of the following: stereotypy, echophenomena, catalepsy, automatic obedience, posturing, negativism, ambitendency
Non-malignant catatonia: criteria A
Delirious mania (excited catatonia): criteria B + severe mania or excitement
Malignant catatonia A or B + fever and autonomic instability
2/2 Mood disorder
2/2 General medical condition or toxic state
2/2 a Brain disorder
2/2 Psychotic disorderFink’s proposed catatonia classification
ATD combined with AP
Abrupt withdrawal from antipsychotic
dopamine agonists BZDantihistaminesanticholinergics
Intoxication with:disulfiramcorticosteroidsPCP, cocaineantihistaminergicsanticholinergicsDrugs associated with MC/NMS