Catatonia in Lewy Body Dementia: New Case Report

Out on PubMed, from authors in North America, is this case report:


The Role of Electroconvulsive Therapy in the Treatment of Catatonia Associated With Lewy Body Dementia: A Case Report.
Sahib Din J, Boes T, Navarro Garcia E, Al-Rubaye H.Cureus. 2024 Jan 18;16(1):e52500. doi: 10.7759/cureus.52500. eCollection 2024 Jan.PMID: 38371130 




The abstract is copied below:

Catatonia is a complex amalgamation of neuropsychiatric symptoms that can manifest in both psychiatric and neurological conditions. The treatment of catatonia related to psychiatric illnesses is well documented as it typically responds to benzodiazepines and electroconvulsive therapy (ECT). However, the treatment of catatonia related to neurological disorders has shown to be more difficult, particularly when associated with Lewy Body Dementia (LBD). Here, we present the case of a 78-year-old woman with LBD, Bipolar I, depressive type, who successfully underwent twelve ECT sessions to treat catatonia refractory to benzodiazepine therapy. The effectiveness of the treatment was measured using the Bush-Françis Catatonia Scale (BFCS) to measure her catatonic symptoms as she progressed through the therapy. This report highlights the importance of considering ECT as a leading therapeutic approach in this particular subset of patients who do not respond adequately to pharmaceutical therapy and medical titrations.

Keywords: benzodiazepines; bush francis catatonia rating scale; catatonia; dementia with lewy bodies; electro-convulsive therapy.

The case report is here.
And from the text:



Here is yet another case of dramatic recovery from catatonia with ECT. The details of the case are interesting, particularly the diagnoses (LBD sans imaging, bipolar disorder), but if the patient gets TOO WELL with ECT, the dementia part may just be suspect. 
My tongue-in-cheek summary of the treatment is: kitchen sink pharmacotherapy, side effects, limited results, ECT, recovery. There is no follow up described, but the plan to discontinue ECT after remission may need to be revised to include maintenance ECT.
This report is also a reminder of the utility of ECT in Parkinson's Disease and related illnesses.
Kudos to these authors for sharing this illustrative good patient outcome.

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