What is Catatonic Disorder of Organic Nature?
Catatonic disorder with organic pathology is relatively rare and occurs in approximately 1/10 of patients suffering from encephalitis.
Causes of Catatonic Disorders of Organic Nature
The catatonia clinic is most common in stem encephalitis, as well as Jacob-Cretzfeldt disease. The occurrence of catatonia always indicates an increase in the severity of the process.
Symptoms of Catatonic Disorders of Organic Nature
In the foreground are the symptoms of the underlying pathology, which is usually detected neurologically. Catatonic syndrome contains typical manifestations of stupor: catalepsy, the absence of arbitrary reactions to a normal stimulus when reacting to a paradoxically minor irritant (Pavlov’s symptom), immobility, mutism, a cogwheel symptom, an airbag; as well as arousal: chaotic, unintended psychomotor agitation, which suddenly interrupts the stupor. However, there is also an atypia associated with an organic background, frequent atonic stupor in which muscle tone is reduced, catalepsy can be accompanied by tremor, eyelid tremor is noticeable, and the symptom of an airbag can be confused with minengeal symptoms. The temperature is often elevated to 40 degrees, due to the underlying disease. Catatonia may be preceded by delirium or disorders of consciousness followed after the disappearance of the clinic of this syndrome.
Diagnosing Catatonic Disorders of Organic Nature
Diagnosis is based on identifying symptoms of the underlying pathology and atypical catatonia.
Febrile catatonia, which often differentiated organic catatonia, is not included in either the DSM or the ICD, this is because careful studies show that such cases actually represent either organic catatonia or a malignant neuroleptic (hyperthermic) syndrome.
The state should be differentiated from the malignant neuroleptic syndrome, catatonic schizophrenia, dissociative and depressive stupor, catatonic disorders in the postpartum period.
Malignant neuroleptic syndrome is caused by hypodofaminergia, it is accompanied by hyperthermia, muscle stiffness, transformation of stupor into amentia and coma, autonomic disorders and vascular permeability disorders. The emergence of the syndrome is promoted by: organic background, intercurrent somatic disorders, agitation, dehydration, increasing the dosage or the rate of administration of the neuroleptic, the combined use of neuroleptics.
Currently, catatonic schizophrenia occurs in the form of microcatatonia, accompanied by negative emotional-volitional disorders. Catatonic disorder in schizophrenia is accompanied by emotional and volitional negative manifestations characteristic of schizophrenia.
Dissociative stupor follows immediately after stress and is more pronounced in the presence of outsiders, in solitude it often disappears.
A depressive stupor is characterized by depressed mimicry, a quiet voice answers against the background of periodic mutism, pupils are dilated, tachycardia. It also follows after stress or at the height of depression, which can be identified in history.
Treatment of Catatonic Disorders of Organic Nature
Treatment should take into account the therapy of the underlying disease, as well as the use of intravenous tranquilizers (Relanium, Sibazon). Frenolone is recommended, small doses of teralene. The use of antipsychotics should be extremely careful, and in small doses.