Catatonia Presentation as a Rare Alcohol Withdrawal Symptom in a Patient With No Past Psychiatry History: A Case Report

Abstract

A complicated alcohol withdrawal syndrome (AWS) includes epileptic seizures and/or delirium tremens (DT). However, there is still a dearth of literature for catatonia as a consequence of AWS especially in terms of clinical reports. Secondly, the few noted reported cases in the literature were mainly of non-American populations. Hence, we present the case of a middle-aged woman with no past psychiatric history admitted for psychosis and altered sensorium with delayed catatonic features in the context of a history of alcohol use disorder. Ms. M., a 44-year-old African American female with no past psychiatric history but a past medical history of gastric bypass surgery, presented to the psychiatric emergency department via emergency medical service due to roaming the street because of acute onset of altered mental status and psychotic features. She had a Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA) score of 33 following last alcohol use a few hours prior to presentation. While on the inpatient unit, the patient had an isolated episode of catatonic stupor despite being administered lorazepam 2mg every four hours as needed. Supportive medical staff should also be aware of catatonia as a rare manifestation of alcohol withdrawal. A persistent, thorough medical workup and evidence-based "investigative" history gathering can help elucidate the source of the presenting symptom in this patient population.

When Consumption Leads to Catastrophe: A Case of Recurrent Alcohol Withdrawal Catatonia in an Adult Patient

“…Even in the absence of observable physiological withdrawal syndrome, catatonia can be an atypical manifestation of alcohol withdrawal [ 3 ]. The conventional benzodiazepine treatment, an established therapeutic choice for both catatonia and alcohol withdrawal, effectively addresses alcohol withdrawal catatonia [ 3 ]. This case shows a recurrent pattern of catatonia during the withdrawal period.…”