Open J Psychiatry Allied Sci. 2023 Jul 31. Epub ahead of print.

Catatonia in Japanese encephalitis: an unusual presentation and treatment challenge.

Tomar V, Singh S.

Background: Catatonia is a syndrome of multiple psychomotor disturbances, occurring in the background of numerous disorders, among which neurological disorders are quite frequent. However, long-standing catatonic symptoms, under such conditions, can pose diagnostic and management dilemma. Case description: Here, we describe a young female patient who developed fever, headache, and altered sensorium, who was diagnosed with Japanese encephalitis (JE). During the illness course, she developed catatonic symptoms, which persisted even after other symptoms had settled. The catatonic symptoms responded minimally to benzodiazepines, which are the first line agents in catatonia. She responded to low-dose of atypical antipsychotics, which are not the usual choice of treatment in organic catatonia. Conclusion: There is dearth of data pertaining to catatonia and more so in Indian context. This report highlights the unusual presentation of JE in the form of catatonia. Secondly, clinicians can explore the possibility of using second-generation antipsychotics for treating such condition, which does require more robust data and further research.

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