Meeting abstract

https://doi.org/10.24869/spsih.2026.296

Differential Diagnostic and Therapeutic Challenges of Catatonia in an Older Woman With Somatic Comorbidities

Petra Folnegović Grošić ; University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia *
Marta Grošić ; School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia
Kristina Jeras ; School of Medicine, University of Zagreb, Šalata 3b, Zagreb, Croatia
Sonja Udovičić ; University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia

* Corresponding author.

Abstract

Introduction: Catatonia is a behavioral syndrome
characterized by an inability to perform normal
movements despite full physical capacity to do
so. The syndrome can occur in numerous psychiatric
and somatic disorders that we encounter
in emergency hospital admission units. Case
presentation: An 88‑year‑old female patient was
referred for a consultative examination with a diagnosis
of catatonia in the context of dementia.
She was brought in from a nursing home because
she had been unresponsive for the previous two
days. Two days earlier, she had been examined
after allegedly falling and hitting her head, after
which she became non‑responsive. Past medical
history: Dementia, atrial fibrillation, and an ischemic stroke three years earlier. One year before
the current episode, she had been hospitalized for
syncope, when a nurse found her with her head
slumped, unable to sit up or speak on her own.
The day before the psychiatric consultation, she
had been examined by a neurologist because she
was unresponsive, staring blankly, and not answering
questions. Due to suspected catatonia,
diazepam 1/2 ampoule 10 mg IV was administered.
Two hours later, the patient became responsive.
The following day, a consultative psychiatrist,
suspecting a possible psychotic basis,
started an antipsychotic (olanzapine 5 mg in the
evening, with oxazepam), after which there was
a renewed deterioration in consciousness. Two
days later, a subsequent consultative psychiatrist
discontinued the antipsychotic and raised suspicion
of neuroleptic malignant syndrome, which
was ruled out by laboratory findings, further observation,
and neurologic examination, as was a
possible infectious process. Lorazepam was introduced
at a dose of 3 × 2.5 mg, later adjusted to
1, 1, and 2.5 mg, with the patient maintaining
adequate contact. Conclusion: Despite the difficulty
of recognition and the numerous differential
diagnostic dilemmas, timely diagnosis and
treatment with benzodiazepines and/or electroconvulsive
therapy, alongside management of
the underlying medical conditions causing catatonia,
are crucial, given that catatonia can be a
life‑threatening condition.

Keywords

catatonia; dementia; neuroleptic malignant syndrome

Hrčak ID:

352992

URI

https://hrcak.srce.hr/352992

Publication date:

15.6.2026.

Article data in other languages: croatian

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