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December 1972

Catatonic Behavior, Viral Encephalopathy, and Death: The Problem of Fatal Catatonia

Author Affiliations

Rochester, NY
From the Department of Psychiatry, Strong Memorial Hospital (Drs. Mandel, Sandt, and Penn); the In-Patient Services, Department of Psychiatry, Strong Memorial Hospital (Dr. Racy); and the Department of Pathology (Neuropathology), University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital (Dr. Lapham). Dr. Penn is currently with McLean Hospital, Belmont, Mass.

Arch Gen Psychiatry. 1972;27(6):758-761. doi:10.1001/archpsyc.1972.01750300030005

The etiology of fatal catatonia, characterized by an agitated psychosis of acute onset which frequently ends in hyperthermia and death, has puzzled clinicians for many years. Controversy has centered around its relationship to schizophrenia. A case report is presented of a man who seemed to have acute schizophrenia, later developing catatonic features; he became hyperthermic and died after nine days despite electroconvulsive therapy and medical support. Postmortem examination revealed microscopic changes in the central nervous system consistent with viral encephalitis. We suggest fatal catatonia may on occasion be the result of a virus acting on the limbic area in particular. Psychiatric presentation and rapid deterioration would create difficulties in diagnosis and management.

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