What is catatonia and why is it dangerous

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

If a person falls into a stupor, speaks poorly and takes a strange posture, he urgently needs the help of a doctor.

What is catatonia

Catatonia Catatonia, or catatonic syndrome, is a condition in which a person becomes immune to external stimuli and loses the ability to move and speak normally.

Until the beginning of the 20th century, it was believed that this happens only with schizophrenia. But then scientists found out Catatonia: pathophysiology, diagnostics and modern approaches to treatment, that more than 50% of cases of catatonia appear with bipolar disorder, about 10-15% are schizophrenia, and 21% are not associated with mental illness at all.

Catatonia is similar to Catatonia - the evolution of views and modern views (literature review) on mental disorders and other diseases, so it is difficult to recognize. For example, with it, as with a stroke, a person may respond with incomprehensible phrases or stop talking altogether. Urgent help is needed in both cases, but it will be different.

Catatonia can develop rapidly or gradually over several days. In the first case, the symptoms are usually strong and obvious; pressure or temperature surges are added to motor and speech disorders. This can lead, for example, to a stroke. In the second option, the symptoms are subtle, and this is the most dangerous: in 3-4 days complications of Catatonia may appear or the person will die.

Imagine a grandmother who has dementia. She often sits on the edge of the bed and looks out the window. But suddenly she spends the whole day like this. Then the grandmother stops talking, reacting to others, but continues to sit. Then she refuses food, water.

The body is exhausted, and 2-3 days after the first symptoms appear, blood clots form in the legs from a long motionless position. At some point, they break off and clog the vessel. The man is dying. But they would have managed to save him if the dangerous symptoms had been noticed on the first day.

Why does catatonia occur?

For the first time, catatonia was described in detail in 1874, but its causes have not yet been established. Scientists have several theories of Catatonia: pathophysiology, diagnostics and modern approaches to treatment, which roughly explain what changes in the body lead to the appearance of symptoms of catatonia.

Some researchers believe that the problem lies in the disruption of the transmission of nerve impulses in those areas of the brain that are responsible for muscle contraction. Others associate catatonia with a change in the balance of neurotransmitters - substances that are produced by neurons in the brain and are involved in cell-to-cell signaling and many biochemical processes. Still others blame an excess or lack of certain hormones of the hypothalamus and pituitary gland, the production of antibodies to brain proteins.

Such disturbances in the work of the body appear in many diseases:

• psychiatric Borisova PO Nosological dilemma and clinical polymorphism of the phenomenon of catatonia. for example bipolar disorder, schizophrenia, autism, depression, anorexia nervosa;
• endocrine: Cushing's syndrome, hyperthyroidism, Sheehan's syndrome and others;
• neurological, eg epilepsy, multiple sclerosis, Parkinson's disease, brain tumors, dementia;
• metabolic - this is when substances accumulate in the body that have a bad effect on the brain: this happens with Wilson-Konovalov disease, an increase and decrease in the concentration of sodium in the blood, renal failure and other diseases;
• autoimmune, such as systemic lupus erythematosus, antiphospholipid syndrome;
• psychoactive substances caused by Catatonia: alcohol, antipsychotics, sedatives, drugs;
• infectious Catatonia: HIV, typhoid fever, tuberculosis, meningoencephalitis, herpes and others;
• vascular, for example, thrombosis of arteries and veins of the brain, stroke, cerebral hemorrhage.

What are the symptoms of catatonia?

Catatonia has many symptoms. The DSM-5, used by psychiatrists around the world, identifies 12 major Catatonia. But doctors add other symptoms to them:

1. Preservation of immobility (stupor).
2. Long-term maintenance of the posture that was given to the body (catalepsy). If a person is seated or placed, he will not move.
3. Prolonged silence (mutism). A person does not respond, even if you refer to him by name. On the contrary, he will most likely turn away.
4. Changing the position of the limbs, like a plasticine figurine (wax flexibility). Some patients easily obey and can carry out any command, like robots.
5. Passive and strong resistance to any attempts to change the position of the arms and legs (negativism). Sometimes it is physically impossible to bend or straighten limbs.
6. Maintaining an uncomfortable posture (posing). For example, a person can bend on the bed without touching the pillow with his head, as if hanging in the air.
7. Pretentiousness of movements (mannerism). A catatonic sufferer may gesture strangely and inappropriately.
8. Repetitive monotonous movement (stereotypy). Remember how in horror movies the possessed constantly sway, tap their fingers, or move their mouths in a creepy way. Most likely, they have an attack of catatonia.
9. Excessive excitement without external stimuli. A person can rush around the room, show aggression, rush at others.
10. Involuntary movements of the lips, eyebrows. Grimaces that are not built to amuse others.
11. Repetition of other people's words (echolalia). Moreover, speech often becomes incoherent, monotonous, words and phrases are pronounced continuously, sometimes for a very long time.
12. Copying other people's movements (echopraxia).

In addition, symptoms may occur Neznanov N. G., Kuznetsov A. V. Clinical and psychopathological aspects of the pathomorphosis of catatonic disorders associated with impaired functioning of the autonomic nervous system. With catatonia, the temperature rises, thirst increases, saliva flows, blood pressure rises and the pulse quickens. Often, patients refuse food and water.

When a doctor makes a diagnosis, he looks for a combination of several signs. But medical attention is needed even if one symptom appears. Otherwise, you can skip not only catatonia, but also a stroke, the onset of schizophrenia, a complication of meningitis or other disease.

How is catatonia treated?

If a person cannot move, does not respond to an appeal to him, an ambulance should be called. If the symptoms are mild, it is important to see a therapist as soon as possible.

From the words of relatives or from the analysis of the medical record, the doctor will establish whether there are mental illnesses, alcohol dependence or other pathologies that can cause catatonia. And if necessary, he will be sent to a psychiatrist.

He will prescribe drug or electroconvulsive therapy as soon as possible.

If there is no danger to the patient's life, the Catatonia examination will help to find the causes of catatonia:

• general blood analysis;
• biochemical research;
• blood electrolyte test;
• liver function tests;
• CT or MRI of the brain.

An electroencephalogram will be done if there is a suspicion of a brain tumor or seizure.

What medications are prescribed

To eliminate catatonia, the psychiatrist uses strong prescription medications. Taking them on your own is dangerous.

First of all, they give Catatonia drugs: pathophysiology, diagnostics and modern approaches to treatment from the group of second-generation anxiolytics based on benzodiazepine. They reduce muscle spasm, soothe, and help relieve the symptoms of catatonia. Benzodiazepines are effective Systematic review of catatonia treatment in 66–100% of patients.

If these drugs do not help, the treatment regimen is changed. Sometimes the best effect is given by alternative Catatonia drugs with sedative, anticonvulsant and muscle relaxant effects. For example, lithium preparations Catatonic syndrome: From detection to therapy will not allow recurrence of an attack of catatonia.

Medicines from the group of neuroleptics are prescribed Catatonia: pathophysiology, diagnostics and modern approaches to treatment are rare: it is impossible to guess how the patient's body will react. On the one hand, drugs can relieve muscle spasm. But at the same time, they can cause neuroleptic malignant syndrome. This is a condition when the temperature, pressure rises and the symptoms of catatonia increase.

When is electroconvulsive therapy used?

Electroconvulsive therapy is a treatment in which an electric current is passed through the brain. It suppresses lesions that emit abnormal impulses and helps relieve muscle spasms and cramps.

Is electroconvulsive therapy an evidence ‑ based treatment for catatonia? A systematic review and meta ‑ analysis if benzodiazepines have proven ineffective or if the patient can. Is electroconvulsive therapy an evidence ‑ based treatment for catatonia? A systematic review and meta-analysis is to die for.

Sometimes, after the application of electroconvulsive therapy, the attacks of catatonia completely stop. But there is a risk Is electroconvulsive therapy an evidence-based treatment for catatonia? A systematic review and meta-analysis of side effects: headache, amnesia, confusion.

How successfully is catatonia treated?

The sooner catatonia is treated, the better for the patient. Quick help can help you avoid complications and save your life.

But not everyone gets well. According to Catatonia statistics, 12-40% of patients are successfully cured. Poor prognosis in children and adolescents with schizophrenia, as well as in the elderly. They may need constant psychiatric help from Catatonia.

If a person has long been suffering from renal failure, alcoholism, Parkinson's disease or other pathology, then the disorders in the brain are already chronic. Therefore, at any time, the catatonic syndrome can recur. Catatonic syndrome: From detection to therapy. In order not to be late with help, you need to remember the dangerous symptoms and follow the doctor's recommendations.

How not to get sick with catatonia

Scientists have not yet learned how to prevent catatonia, like other mental illnesses or brain tumors. But, given the causes of the syndrome, the following can be advised:

• Reduce alcohol consumption, and for addiction symptoms, get treatment.
• Never use drugs.
• Don't ignore the symptoms of depression.
• Do not take hypnotics, sedatives, antipsychotics without the appointment of a specialist. Catatonia: pathophysiology, diagnostics and modern approaches to treatment.
• Consult a doctor for headaches, dizziness, flies in the eyes.
• Treat kidney and liver diseases in time.
• Avoiding casual sex to protect against HIV and syphilis.
• Monitor weight and avoid stress, so as not to worsen the condition of blood vessels.
• Pregnant women register on time and follow the doctor's recommendations so that the birth goes well.
• Try not to injure your head.