Catatony in Graves' disease

We report a 27-year-old female patient with prior history of Graves' diseas e and relapsing episodes of tachycardia, hyperpyrexia, muscular rigidity an d coma. With the subsequent manifestation of an acute schizophreniform psyc hotic disorder unresponsive to neuroleptics, the primary syndrome was re-cl assified as febrile catatony. Hyperthyroidism was ruled out with normal ser um thyroid hormone levels, as were toxic effects of thyrostatic treatment, drug-induced hypothyroidism and a malignant neuroleptic syndrome. All psych iatric symptoms subsided completely following subtotal thyroidectomy. Febri le catatatony has to be added to the spectrum of psychotic phenomena that m ay be caused by Graves' disease, irrespective of serum thyroid hormone leve ls. (C) 1998 Elsevier, Paris.