Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient

Catatonia is an illness that overlaps with depression, dementia, and delirium, creating a diagnostic challenge. We present a case of catatonia in an older patient who initially presented with hypoactive delirium and who was later determined to have progressive dementia. Her physical examination show...

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Main Authors: Mallika Lal, Katie Drago, Rebecca Harrison
Format: Article
Language:English
Published: American College of Physicians 2024-07-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2023.1324
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author Mallika Lal
Katie Drago
Rebecca Harrison
author_facet Mallika Lal
Katie Drago
Rebecca Harrison
author_sort Mallika Lal
collection DOAJ
description Catatonia is an illness that overlaps with depression, dementia, and delirium, creating a diagnostic challenge. We present a case of catatonia in an older patient who initially presented with hypoactive delirium and who was later determined to have progressive dementia. Her physical examination showed signs of echopraxia, mitmachen, mutism, staring, a withdrawn affect, and a marked response to lorazepam, leading to the diagnosis of catatonia. An extensive work-up for an underlying cause was unrevealing. Catatonia was thought to be related to underlying Lewy body dementia in this patient. Our case illustrates the importance of early recognition of catatonia, especially in older patients.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-db57e40d7d4c4db0bc9f37ef1854bb912025-08-20T02:12:57ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642024-07-013710.7326/aimcc.2023.1324Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized PatientMallika Lal0Katie Drago1Rebecca Harrison21Department of Medicine, Oregon Health and Science University, Portland, Oregon1Department of Medicine, Oregon Health and Science University, Portland, Oregon1Department of Medicine, Oregon Health and Science University, Portland, OregonCatatonia is an illness that overlaps with depression, dementia, and delirium, creating a diagnostic challenge. We present a case of catatonia in an older patient who initially presented with hypoactive delirium and who was later determined to have progressive dementia. Her physical examination showed signs of echopraxia, mitmachen, mutism, staring, a withdrawn affect, and a marked response to lorazepam, leading to the diagnosis of catatonia. An extensive work-up for an underlying cause was unrevealing. Catatonia was thought to be related to underlying Lewy body dementia in this patient. Our case illustrates the importance of early recognition of catatonia, especially in older patients.https://www.acpjournals.org/doi/10.7326/aimcc.2023.1324
spellingShingle Mallika Lal
Katie Drago
Rebecca Harrison
Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
Annals of Internal Medicine: Clinical Cases
title Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
title_full Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
title_fullStr Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
title_full_unstemmed Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
title_short Thinking Twice About Benzodiazepines: Treatment of Progressive Dementia in a Hospitalized Patient
title_sort thinking twice about benzodiazepines treatment of progressive dementia in a hospitalized patient
url https://www.acpjournals.org/doi/10.7326/aimcc.2023.1324
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