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Psychiatric manifestations of encephalitis.

Ann Clin Transl Neurol

January 2025

Department of Neurology, Johns Hopkins Encephalitis Center, Johns Hopkin School of Medicine, Baltimore, Maryland, USA.

Objective: Encephalitis is a serious and potentially life-threatening condition of infectious or autoimmune cause. We aim to characterize the frequency and clinical spectrum of presenting psychiatric symptoms in encephalitis in order to inform earlier recognition and initiation of treatment.

Methods: This was a retrospective study of adult patients who met the 2013 International Encephalitis Consortium (IEC) and/or 2016 Graus criteria between February 2005 and February 2023.

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Objective: Benzodiazepines, particularly lorazepam, are good options for acute catatonia treatment. Published catatonia literature on benzodiazepine maintenance treatment and benzodiazepine tolerance is limited.

Methods: This is a chart review covering 30 years of clinical experience in the state of Kentucky, (United States of America), where there was no easy access to electroconvulsive therapy.

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Bromocriptine for Residual Catatonia Following Neuroleptic Malignant Syndrome: Illustrative Case Report and Systematic Review.

J Acad Consult Liaison Psychiatry

January 2025

Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA, 33613; Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, 32608.

Background: Neuroleptic malignant syndrome (NMS) is a rare yet potentially fatal iatrogenic syndrome that can manifest with life-threatening symptoms. Theorized to be caused by the dopamine-blocking effects of certain medications, such as antipsychotics, or the withdrawal of dopaminergic agents, NMS is characterized by hyperthermia, autonomic instability, altered mental status, and muscular rigidity. Most treated cases resolve within weeks; however, in some cases, residual catatonic symptoms can persist for months after the resolution of acute hyperthermic and hypermetabolic symptoms.

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Catatonia is one of the most severe psychiatric syndromes, and clinical symptoms and etiology are very heterogeneous. When accompanied by autonomic instability and hyperthermia it’s termed malignant catatonia, which left untreated is associated with significant morbidity and mortality. First-line treatment is high dose benzodiazepines, followed by electroconvulsive therapy (ECT), in case of non-response.

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Since its first inception by Kahlbaum in relation to schizophrenia, Catatonia syndrome is currently believed to cut across many neuropsychiatric diagnoses. In this focussed review, authors touch briefly on prevalence of catatonia in psychiatric presentations, discuss clinical diagnosis, neurobiology, typology, and conclude with a psychopharmacological algorithm to treatment.

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