RECOGNITION AND TREATMENT OF THE CATATONIC SYNDROME

We define the catatonic syndrome and review the history of the concept of catatonia, including its recent acceptance as a syndrome. Diagnosi s of the catatonic syndrome, with its associated extensive differentia l diagnoses related to systemic and mental disorders, is addressed. Ca tatonia is related to variants of the syndrome, such as lethal (malign ant) catatonia and the neuroleptic malignant syndrome (NMS). Medical s equelae of these conditions are outlined. The Literature on the treatm ent of the catatonic syndrome is reviewed, and a suggested approach to treatment and management of catatonic patients in the intensive care unit is provided. An hypothesis regarding the neuropathophysiological basis for the syndrome is also offered.