The present paper is the presentation of a case that exposes a positive and differential diagnosis controversy, in the context of a catatonic syndrome with a sudden onset, occurring in an apparent state of mental health, in a patient of 42 years old, without personal or heredocolateral psychiatric history, with normal premorbid functioning. Its purpose is to emphasize the importance of excluding organicity in the case of catatonic syndrome and to make it aware that the impact of the often impressive psychotic symptoms should not overshadow the detection of potentially life-threatening somatic symptoms. The presented case underlines precisely the dilemma of establishing the etiology of catatonic syndrome, between endogenous causes and underdiagnosed meningeal reaction.
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