Case Report-Catatonia in an Adolescent

Out on PubMed, from clinicians in Louisiana, is this case report:

Treatment of a Complex Case of Catatonia and Conversion Features With Electroconvulsive Therapy in a 14-Year-Old Male.

Roi C, Verret L, Peet B, Conrad EJ.Ochsner J. 2020 Fall;20(3):307-310. doi: 10.31486/toj.19.0026.PMID: 33071665
The abstract is copied below:
Background: Pediatric catatonia is a rare and poorly understood phenomenon. The majority of reported cases have a psychiatric etiology. Because of the heterogeneous presentation and treatment issues unique to the pediatric population, identification and management can be challenging. Additionally, few definitive guidelines or practice parameters are available for pediatric patients. The first-line treatment for catatonia is pharmacologic, and when treatment fails or is inadequate, electroconvulsive therapy (ECT) has been shown to be safe and effective. Case Report: A previously healthy, 14-year-old male presented with acute onset of catatonia that resolved at 4 weeks after a short course of ECT with adjunctive lorazepam and risperidone. An interesting feature of this case was the resolution of autonomic symptoms and the emergence of conversion features. The resolution of the catatonia (negativism, mutism, and withdrawal) made it possible for the team to identify a thought disorder and initiate appropriate pharmacologic treatment for the precipitating etiology. Conclusion: ECT was a safe and effective treatment for the resolution of catatonia symptoms in this patient. Conversion and catatonia features may exist on a continuum.

Keywords: Catatonia; conversion disorder; electroconvulsive therapy; mental disorders.

The pdf is here.

This is an interesting and instructive case report. ECT for catatonia in adolescents is still uncommon enough that case reports are useful to increase the evidence base. 
The dramatic response to the first ECT is not unusual; unfortunately the relapse before the delayed second treatment is not either. The use of risperidone and the diagnosis of conversion disorder seem questionable, but, of course, one should be cautious in second-guessing the clinicians who were actually there treating the patient.
The good outcome speaks for itself...

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