Reversal of Preoperative Catatonic State by Surgical Resection of an Adult-onset Craniopharyngioma

Abstract

To describe a case of a rare adult-onset craniopharyngioma presenting as rapidly progressive catatonia that was reversed after surgical resection of the tumor. Profoundly depressed states of awareness classified as either catatonia or akinetic mutism have been reported in patients with hypothalamic neoplasms, but reports of improvement in consciousness level after surgical resection are rare and limited to very large tumors. Medical, neurologic, and psychiatric histories, physical examination findings, laboratory workup results, pathologic and imaging studies, and response to surgical treatment were documented. The patient showed progressive improvement in mental status and overall neurologic function after surgical treatment. The search for an etiology of a profound catatonic state should include the probability of a suprasellar/hypothalamic lesion, which in this case was owing to the rare finding of an imaging-documented adult-onset craniopharyngioma.