Dr. Rummans replies

Abstract

I thank Drs. Heye and Dunne for their comments about our case of malignant catatonia. We were amiss for not including the results of the electroencephalographic examination that was performed as part of the comprehensive neurologic and medical assessment of our patient. The electroencephalographic findings revealed a dysrhythmia, grade 2, consistent with a diffuse disturbance of cerebral function rather than nonconvulsive status epilepticus. Although our patient did not have nonconvulsive status epilepticus, I agree with Drs. Heye and Dunne that this condition should be considered in the differential diagnosis of a patient whose clinical findings are similar to those of our patient. Consequently, an electroencephalogram should be included as part of the assessment of such patients. Malignant Catatonia or Nonconvulsive Status Epilepticus?Mayo Clinic ProceedingsVol. 70Issue 1PreviewIn the July 1994 issue of the Mayo Clinic Proceedings (pages 645 to 650), Boeve and colleagues diagnosed malignant catatonia in a 69-year-old man with progressive behavioral changes and depression, who ultimately became rigid, tremulous, and mute. He “experienced a striking but shortlived improvement” after 1 mg of lorazepam was given intravenously before lumbar puncture. Later, autonomic instability with blood pressure changes, tachycardia, altered respiration, and fever developed. Emergency electroconvul-sive therapy was necessary. Full-Text PDF