Catatonia

Abstract

Wilson's disease (WD) or hepatolenticular degeneration is a rare inherited disorder of copper metabolism affecting both the liver and the central nervous system. Psychiatric manifestations may precede neurological signs in the early stages of WD, but catatonia is a rare presentation. Here, we report a case of an 18-year-old girl who presented to the psychiatry outpatient department with catatonia. She was subsequently diagnosed to have WD. Her symptoms improved on treatment with trientine, trihexyphenidyl, zinc acetate, and benzodiazepine.

Evidence-based consensus guidelines for the management of catatonia: Recommendations from the British Association for Psychopharmacology

“…All patients had a schizophrenia-spectrum illness. And in a fourth case, several medications including trihexyphenidyl were used to treat catatonia in a young woman with Wilson’s disease (Davis et al, 2021).…”

“…Malignant catatonia may be a rare cause of liver failure (Kiparizoska et al, 2021). Catatonia has been reported secondary to Wilson’s disease (Davis et al, 2021), after liver transplantation (Chung et al, 2013; Cottencin et al, 2002; Huang et al, 2006; Kalivas and Bourgeois, 2009; Tatreau et al, 2018), including in post-transplantation delirium (Brown et al, 2016; Kahn, 2016) as well as secondary to post-transplantation drug toxicities (Davis and Tripathi, 2020). The early post-liver transplantation period may be a state of deficiency in GABA signalling (Tatreau et al, 2018), which may place the patient at increased risk for catatonia.…”