Secondary Acute Lethal Catatonia

Abstract

At various times attempts have been made to establish a specific pathological entity “acute lethal catatonia”. Stauder and Scheid (quoted by Mayer Grosset al., 1954) among the older writers have collected a number of fatal cases and more recently Locher (1941) has suspected qualitative difference in the type of illness of those mental patients who die suddenly in an acute catatonic state. However the general view nowadays seems to be that death is due to exhaustion or intercurrent illness. A fatal outcome is very unusual in current practice perhaps because of improved therapy. The symptoms of acute catatonic schizophrenia are so striking that a determined quest for a biochemical basis for the whole schizophrenic process has been sought in this, its most dramatic manifestation. Success in this direction has often been claimed (e.g. Fischer, 1953; Rieder, 1954; Gjessing, 1953,inter alia) but has also frequently been disputed (Georgi, Rieder and Weber, 1954). The following case is reported because the symptoms seemed to be clearly related to physiological change. It tends also to throw further doubt on the entity of acute lethal catatonia of Locher. Interesting EEG findings and characteristic response to amytal are also noted.