Recurrent opisthotonus in catatonia: An atypical presentation

Manjunatha, Narayana; Mehta, Urvakhsh Meherwan; John, Philip

doi:10.4103/0019-5359.58881

Cited by 7 publications

(8 citation statements)

References 11 publications

(4 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Maple syrup urine disease [17] Meningitis [18,19] Monoamine neurotransmitter defect [20,21] Encephalitis [22,23] Wilson disease [24] Tetanus [1,[25][26][27][28] Neurodegeneration with brain iron accumulation (NBIA), e.g., pantothenate kinase-associated neurodegeneration (PKAN) [15] Rabies [29] Other genetic disorders 1 [21,30] Neurosyphilis [31] Cerebral malaria [12] Toxins/elevated toxic metabolites Kernicterus [12] Strychnine [32] Phencyclidine [32] Phenothiazines [32] Propofol [33,34] Methoxphenidine [35] Neonatal caffeine overdose [32] Increased Intracranial Pressure Subarachnoid hemorrhage [5] Intracerebral hemorrhage [5] Hydrocephalus [36] Mass/Tumor [36] Autoimmune…”

Section: Infectious/post-infectiousmentioning

confidence: 99%

See 1 more Smart Citation

Botulinum Neurotoxin Injections in Childhood Opisthotonus

Hull

Parnes

Jankovic

2021

Toxins

View full text Add to dashboard Cite

Opisthotonus refers to abnormal axial extension and arching of the trunk produced by excessive contractions of the paraspinal muscles. In childhood, the abnormal posture is most often related to dystonia in the setting of hypoxic injury or a number of other acquired and genetic etiologies. The condition is often painful, interferes with ambulation and quality of life, and is challenging to treat. Therapeutic options include oral benzodiazepines, oral and intrathecal baclofen, botulinum neurotoxin injections, and deep brain stimulation. Management of opisthotonus within the pediatric population has not been systematically reviewed. Here, we describe a series of seven children who presented to our institution with opisthotonus in whom symptom relief was achieved following administration of botulinum neurotoxin injections.

show abstract

Section: Infectious/post-infectiousmentioning

confidence: 99%

“…Stiff-person syndrome [37] Anti-NMDA receptor encephalitis [22] Other Functional (psychogenic) dystonia [3,4,38] Tardive dystonia [6,30,[39][40][41][42][43] Malignant catatonia [29] Brainstem/cerebellar malformation [44] Epilepsy [12] 1 Any genetic syndromes with prominent dystonia have the potential to manifest opisthotonus.…”

Section: Infectious/post-infectiousmentioning

confidence: 99%

Botulinum Neurotoxin Injections in Childhood Opisthotonus

Hull

Parnes

Jankovic

2021

Toxins

View full text Add to dashboard Cite

show abstract

“…The very early age at onset, delayed motor milestones, truncal hypotonia, encephalopathic crisis, and intermittent painful dystonic posturing exacerbated by fever or infections are helpful clues to suspect a neurometabolic disease (see Table ) . Conditions that reportedly cause back arching because of different etiologies, such as tetanus, strychnine poisoning, meningitis, and encephalitis, or “arc‐de‐cercle” in psychogenic dystonia are less likely to pose differential diagnostic problems with NBIAs …”

Section: How Common Is Dystonic Opisthotonus In Nbias?mentioning

confidence: 99%

“…39,41 Conditions that reportedly cause back arching because of different etiologies, such as tetanus, strychnine poisoning, meningitis, and encephalitis, or "arc-de-cercle" in psychogenic dystonia are less likely to pose differential diagnostic problems with NBIAs. 35,[42][43][44][45][46] Which Is the Possible Pathophysiology?…”

Section: Differential Diagnosis Of Dystonic Opisthotonusmentioning

confidence: 99%

Dystonic opisthotonus: A “red flag” for neurodegeneration with brain iron accumulation syndromes?

et al. 2013

View full text Add to dashboard Cite

Back arching was reported in one of the very first patients with neurodegeneration with brain iron accumulation syndrome (NBIAs) published in 1936. However, recent reports have mainly focused on the genetic and imaging aspects of these disorders, and the phenotypic characterization of the dystonia has been lost. In evaluating patients with NBIAs in our centers, we have observed that action-induced dystonic opisthotonus is a common and characteristic feature of NBIAs. Here, we present a case series of patients with NBIAs presenting this feature demonstrated by videos. We suggest that dystonic opisthotonus could be a useful “red flag” for clinicians to suspect NBIAs, and we discuss the differential diagnosis of this feature. This would be particularly useful in identifying patients with NBIAs and no iron accumulation as yet on brain imaging (for example, as in phospholipase A2, group IV (cytosolic, calcium-independent) [PLA2G6]-related disorders), and it has management implications. © 2013 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

show abstract

“…Opisthotonos after Administration of Intramuscular Ketamine administration of phenothiazines and propofol, and poisoning involving strychnine. [4][5][6][7][8] The patient's presentation and rapid recovery suggest against any of these alternative etiologies. Opisthotonos has been reported in intoxication with the other major arylcyclohexamine N-methyl-D-aspartate (NMDA) receptor antagonists (other than ketamine) such as phencyclidine and methoxetamine, making it biologically plausible that ketamine could have caused the reaction.…”

Section: Morgan Et Almentioning

confidence: 99%

A Case Report of Opisthotonos Associated with Administration of Intramuscular Ketamine

Morgan

Dore

2021

Clinical Practice and Cases in Emergency Medicine

View full text Add to dashboard Cite

Introduction: Ketamine, a commonly used medication to treat agitation, has known adverse effects such as emergence reactions, vomiting, and laryngospasm. Opisthotonos has not been a commonly reported adverse reaction. Case Report: We report a case of opisthotonos brought on by administration of ketamine. A 24-year-old male with a history of schizophrenia was brought in by emergency medical services with opisthotonos shortly after treatment with 250 milligrams intramuscular ketamine by paramedics. He had become increasingly paranoid after being off his aripiprazole for a few weeks, and his family had become afraid for his and their safety. Paramedics administered ketamine to control his combative agitation, per protocol. The patient’s extreme neck and back extension rapidly resolved with the administration of midazolam. Further history and workup did not reveal another cause for opisthotonos. Conclusion: This is the first reported case to our knowledge of ketamine-associated opisthotonos in the emergency setting. Emergency care providers should be aware of this potential side effect.

show abstract

Recurrent opisthotonus in catatonia: An atypical presentation

Abstract: ABSTRACT

Cited by 7 publications

References 11 publications

Botulinum Neurotoxin Injections in Childhood Opisthotonus

Botulinum Neurotoxin Injections in Childhood Opisthotonus

Dystonic opisthotonus: A “red flag” for neurodegeneration with brain iron accumulation syndromes?

A Case Report of Opisthotonos Associated with Administration of Intramuscular Ketamine

Contact Info

Product

Resources

About