AI Article Synopsis
- An adolescent female with benzodiazepine-resistant malignant catatonia initially did not respond to single-stimulation electroconvulsive therapy (ECT) but showed improvement with multiple monitored ECT (mmECT).
- The use of mmECT was justified due to her life-threatening condition and the brief seizures experienced during single-stimulation ECT, supporting its consideration for intractable cases.
- After treatment, the patient's condition significantly improved, as seen in her decreased Catatonia Rating Scale score, and she successfully returned to school without needing ongoing ECT at a 2-year follow-up.
Article Abstract
We report a case of an adolescent female experiencing benzodiazepine and single-stimulation electroconvulsive (ECT)-refractory malignant catatonia, who improved with the use multiple monitored ECT (mmECT). Per the 2001 American Psychiatric Association guidelines, mmECT should be considered only in cases of intractable seizures or neuroleptic malignant syndrome. Since 2001, neuroleptic malignant syndrome and malignant catatonia have been described as occurring along the same spectrum of illness. Therefore, given the life-threatening nature of her condition, as well as the brief seizure duration she experienced from single-stimulation ECT, the patient was treated with en-bloc and 2-stimulation mmECT. The patient demonstrated a significant improvement in response to this treatment, with her Bush-Francis Catatonia Rating Scale score decreasing by 89%. At 2-year follow-up in an outpatient neurodevelopmental catatonia clinic, the patient has been able to return to school in her previous advanced placement classes and has not required maintenance ECT.
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