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• Vol.50 No.5
• CLINICA NEUROL, 50: 329−331, 2010
• Vol.50 No.5 contents

Brief Clinical Note

A patient with encephalitis presenting with olanzapine-responsive malignant catatonia

Hayato Suzuki, M.D., Takao Fukushima, M.D., Ph.D., Kunihiko Makino, M.D., M.S. and Takeo Kuwabara, M.D., Ph.D.

Department of Neurology, Shibata Hospital-Niigata Preferctural Hospital

We report the case of a 29 year-old man, who could not remember some words of Kanji and showed emotional instability. Magnetic resonance imaging (MRI) scan of his brain appeared normal. Cerebrospinal fluid (CSF) analysis showed lymphocytic pleocytosis. An electroencephalogram (EEG) showed slow activities in both frontal regions of the brain. He was diagnosed as acute encephalitis. On his fourth hospital day, he was found to be catatonic and showed mutism, akinetism, and catalepsy. On the ninth day, he showed hyperpyrexia, muscle rigidity, difficulty in swallowing, respiratory insufficiency, and rhabdomyolysis (creatine phosphokinase (CK), 3,038 IU/l). He was diagnosed as malignant catatonia. Intravenous administration of acyclovir, high-dose methylprednisolone, antibiotics, diazepam, and dantrolene sodium was not effective. After initiating oral administration of olanzapine, his condition improved.
Full Text of this Article in Japanese PDF (463K)

(CLINICA NEUROL, 50: 329−331, 2010)
key words: Malignant catatonia, catalepsy, olanzapine, hypercreatine kinasemia, acute encephalitis

(Received: 15-Sep-09)