ECT in the Treatment of Catatonia in a patient with Budd Chiari syndrome: New Case Report.
Out on PubMed, from authors in New Jersey and Ohio, is this case report:
Electroconvulsive therapy in the treatment of catatonia in a patient with Budd Chiari syndrome: a case report.
Neurocase. 2025 Jan 16:1-4. doi: 10.1080/13554794.2024.2446316. Online ahead of print.PMID: 39817652
The abstract is copied below:
Catatonia may manifest as an independent entity or as a feature of a neuropsychiatric or medical illness. While electroconvulsive therapy (ECT) is the gold standard treatment for catatonia, it is typically administered if the patient's symptoms fail to respond to benzodiazepines. We describe the case of a 22-year-old male with Budd Chiari induced cirrhosis and no prior psychiatric history, who presented with symptoms of psychosis and hepatic encephalopathy, was treated in the ICU for multi-factorial delirium, developed symptoms of catatonia that failed to respond to lorazepam, ultimately requiring ECT with a favorable response. This report hopes to add to the literature by discussing potential etiologies of catatonia and by providing an illustrative example of the treatment of catatonia and its considerations in patients with hepatic impairment.
Keywords: Budd Chiari syndrome; Electroconvulsive therapy; catatonia; hepatic encephalopathy; lorazepam challenge test.
The paper is here.
Here is yet another case of catatonic symptoms quickly resolved with ECT. On the negative side, it is also a case where ECT was stopped too soon, and needed to be started again. The choice of RUL-UBP ECT seems questionable in such an urgently ill patient.
And the text does not specifically use the term "neuroleptic malignant syndrome" or "NMS", although this is discussed as the most likely etiology of the catatonia.
Despite these shortcomings, let us still give kudos to these authors for their contribution to the catatonia/ECT literature.
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