Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient

Catatonia is an illness that overlaps with depression, dementia, and delirium, creating a diagnostic challenge. We present a case of catatonia in an older patient who initially presented with hypoactive delirium and who was later determined to have progressive dementia. Her physical examination show...

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Bibliographic Details
Main Authors: Mallika Lal, Katie Drago, Rebecca Harrison
Format: Article
Language:English
Published: American College of Physicians 2024-07-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.1324
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Summary:Catatonia is an illness that overlaps with depression, dementia, and delirium, creating a diagnostic challenge. We present a case of catatonia in an older patient who initially presented with hypoactive delirium and who was later determined to have progressive dementia. Her physical examination showed signs of echopraxia, mitmachen, mutism, staring, a withdrawn affect, and a marked response to lorazepam, leading to the diagnosis of catatonia. An extensive work-up for an underlying cause was unrevealing. Catatonia was thought to be related to underlying Lewy body dementia in this patient. Our case illustrates the importance of early recognition of catatonia, especially in older patients.
ISSN:2767-7664