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- Title
Unfolding the mystery: Rare presentation of Japanese encephalitis as catatonia.
- Authors
Doval, Nimisha; Kar, Sujita Kumar; Malhotra, Hardeep Singh
- Abstract
Catatonia is a syndrome of specific motor abnormalities, closely associated with disorders of mood, thought, and cognition. The principal symptoms of catatonia are mutism, immobility, negativism, posturing, stereotypy, and echo phenomena. Catatonia occurs in various psychiatric illnesses as well as medical disorders like infections of the central nervous system such as encephalitis, autoimmune disorders, cerebrovascular events, systemic metabolic disturbances, and toxic drug states. Catatonia may often mislead the clinician and the patient may be misdiagnosed as primarily suffering from a psychiatric disorder and be treated accordingly. Encephalitis may present with various psychiatric symptoms including catatonic features as its sequel that may sometimes be misunderstood as a primary psychiatric disorder. We highlight a case of a young female in her postpartum period, who presented with initial aggressive behavior and sleep deprivation followed by features of catatonia accompanied with fever. She initially responded well to benzodiazepines; however, her subsequent response was poor. When she was subjected to neuroimaging, it revealed signal intensity alteration in the bilateral basal ganglia and temporal regions suggestive of encephalitis; cerebrospinal fluid (CSF) viral markers examination revealed immunoglobulin M (IgM) positivity for Japanese encephalitis (JE). This case report highlights the diagnostic dilemma and management issues of a case of JE with catatonic symptoms.
- Subjects
ENCEPHALITIS; JAPANESE people; CATATONIA; PATIENTS; DISEASES
- Publication
International Journal of Nutrition, Pharmacology, Neurological Diseases, 2015, Vol 5, Issue 4, p159
- ISSN
2231-0738
- Publication type
Article
- DOI
10.4103/2231-0738.167499