Catatonia in Sjögren's Syndrome

Out on Pubmed, from clinicians in Japan, is this case report:

 Case of Prolonged Catatonia Caused by Sjögren's Syndrome.

Inagaki T, Kudo K, Kurimoto N, Aoki T, Kuriyama K.Case Reports Immunol. 2020 Nov 3;2020:8881503. doi: 10.1155/2020/8881503. eCollection 2020.PMID: 33204547 
The pdf is here.
And from the text:
[This 58-year old woman]...received a 20-session course of ECT within a period of 10 weeks. (there were no adverse effects that interfered with the treatment, except for minor temporal delirium. Her catatonia was obviously improved along with the other depressive symptoms, including appetite loss and decline in locomotor activity. One week after the final ECT session, her pressure sores had completely resolved, and we were able to collect cerebrospinal fluid through a lumbar puncture for cytological examination. (results showed an increased cell count (10/μL), elevated IgG levels (14.3 mg/dL), and elevated interleukin-6 levels (5.14 pg/mL). (specific gravity and protein levels were within the normal limits. Based on these observations, we confirmed the diagnosis of neuropsychiatric SS [Sjogren's Syndrome]. Following steroid pulse therapy, she has not experienced catatonia for more than 5 years without the need for psychiatric treatments (e.g., antidepressants and ECT).

This is a straightforward case report of catatonia occuring in the context of a chronic autoimmune disorder. No details of the ECT were provided, other than the number of treatments.
I did learn a new word from the text of the case report: albocinereous. It means, "referring to both the white and gray matter." It derives from the latin for "white"  and "ashes". 

Comments

Post a Comment

Popular posts from this blog

ECT vs Ketamine: NEJM Article Sets Up False Equivalency

Image
Out on PubMed, from investigators in the US, is this study: Ketamine versus  ECT   for Nonpsychotic Treatment-Resistant Major Depression. Anand A, Mathew SJ, Sanacora G, Murrough JW, Goes FS, Altinay M, Aloysi AS, Asghar-Ali AA, Barnett BS, Chang LC, Collins KA, Costi S, Iqbal S, Jha MK, Krishnan K, Malone DA, Nikayin S, Nissen SE, Ostroff RB, Reti IM, Wilkinson ST, Wolski K, Hu B. N Engl J Med. 2023 May 24. doi: 10.1056/NEJMoa2302399. Online ahead of print. PMID:  37224232 The abstract is copied below: Background:  Electroconvulsive therapy (ECT) and subanesthetic intravenous ketamine are both currently used for treatment-resistant major depression, but the comparative effectiveness of the two treatments remains uncertain. Methods:  We conducted an open-label, randomized, noninferiority trial involving patients referred to ECT clinics for treatment-resistant major depression . Patients with treatment-resistant major depression without psychosis were recruited and assigned in a 1:1 rat
Read more

RUL ECT vs Low Amplitude Seizure Therapy (LAP-ST)

Image
Out on PubMed, from the team in Augusta, Georgia, is this study: Double-Blinded Randomized Pilot Clinical Trial Comparing Cognitive Side Effects of Standard Ultra-Brief Right Unilateral ECT to 0.5 A Low Amplitude Seizure Therapy (LAP-ST). Youssef NA, McCall WV, Ravilla D, McCloud L, Rosenquist PB. Brain Sci. 2020 Dec 13;10(12):E979. doi: 10.3390/brainsci10120979. PMID:  33322138 The pdf is here . And from the Introduction : In theory, LAP-ST can be helpful because of the direct effect of lower electric current, but the principal reason is that LAP-ST has a more focal electric field (EF) [ 34 , 35 ]. The current amplitude is the primary factor that drives the EF into brain regions located deeper in the brain and is responsible for cognition and memory such as the hippocampus and temporal lobe [ 33 , 35 ]. This extra focality of the EF can minimize or avoid high EF stimulation to the deeper hippocampal and temporal lobe regions [ 33 , 35 ]. Minimization of deeper stimulation by using LAP
Read more

ECT For Children at a University Hospital: New Study in JECT

Image
 Out on PubMed, from authors at Vanderbilt and Mass General,, is this article: Use of   ECT   for Children With and Without Catatonia: A Single-Site Retrospective Analysis. Smith JR, Baldwin I, Termini KA, McGonigle T, Vandekar S, Luccarelli J. J ECT. 2024 Jan 25. doi: 10.1097/YCT.0000000000000993. Online ahead of print. PMID:  38265759 The abstract is copied below: Objectives: The objective study was to investigate the safety and efficacy of electroconvulsive therapy (ECT) in a retrospective cohort of pediatric patients. Methods: A single-site retrospective analysis was conducted of patients aged younger than 18 years who received ECT in a private university hospital from January 28, 2012 to April 8, 2023. Treatment efficacy and adverse events were determined retrospectively through review of the medical record. Results: A total of 36 pediatric patients met the inclusion criteria. Catatonia was the most common presenting indication for ECT, followed by psychosis and suicidal ideation.
Read more