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Symptoms include: rigid body, rigid limbs, limbs staying in same position when moved (waxy flexibility), no response, loss of muscle control, and slowing down of bodily functions, such as breathing.
Catalepsy is a symptom of certain nervous disorders or conditions such as Parkinson's disease and epilepsy. It is also a characteristic symptom of cocaine withdrawal, as well as one of the features of catatonia. It can be caused by schizophrenia treatment with anti-psychotics, such as haloperidol, and by the anesthetic ketamine. Protein kinase A has been suggested as a mediator of cataleptic behavior.
People with catatonia may experience an extreme loss of motor skill or even constant hyperactive motor activity. Catatonic patients will sometimes hold rigid poses for hours and will ignore any external stimuli. People with catatonic excitement can suffer from exhaustion if not treated. Patients may also show stereotyped, repetitive movements.
They may show specific types of movement such as waxy flexibility, in which they maintain positions after being placed in them by someone else. Conversely, they may remain in a fixed position by resisting movement in proportion to the force applied by the examiner. They may repeat meaningless phrases or speak only to repeat what the examiner says.
While catatonia is only identified as a symptom of schizophrenia in present psychiatric classifications, it is increasingly recognized as a syndrome with many faces. It appears as the Kahlbaum syndrome (motionless catatonia), malignant catatonia (neuroleptic malignant syndrome, toxic serotonin syndrome), and excited forms (delirious mania, catatonic excitement, oneirophrenia).
It has also been recognized as grafted on to autism spectrum disorders.
Fink and Taylor developed a catatonia rating scale to identify the syndrome. A diagnosis is verified by a benzodiazepine or barbiturate test. The diagnosis is validated by the quick response to either benzodiazepines or electroconvulsive therapy (ECT). While proven useful in the past, barbiturates are no longer commonly used in psychiatry; thus the option of either benzodiazepines or ECT.
List of symptoms that has been observed in those with autistic catatonia:
- Stupor
- Mutism
- Hyperactivity
- Agitation
- Excitement
- Posing
- Negativism
- Rigidity
- Waxy flexibility
- Automatic obedience
- Combativeness (during excitement)
- Aggressivity
- Stereotypies
- Tics
- Grimacing
- Echolalia
- Echopraxia
- Perseveration
- Verbigeration
- Staring
- Withdrawal
- Immobility
- Challenging behaviour
- Tremor
- Slowness
- Amotivation
- Grasp reflex
- Mannerism
- Gaze fixation
- Choreoathetoid movements of the trunk and extremities
- Autonomic instability (during excitement)
- Cannot start actions
- Cannot stop actions (if during excitement episodes needs acute psychiatric care)
- Freezing
- Impulsivity
- Bizarre/psychotic
- Sleep problems
- Urinary or Fecal incontinence
- Odd gait
- Passivity
- Reversal of day and night
- Eyerolling
- Stiff muscles
- Catalepsy
- Physiological pillow
- Difficulty crossing lines
- Gegenhalten
- Mitgehen
- Mitmachen
- Ambitendency
- Rituals
Autistic catatonia is a rare type of disorder that affects roughly 10 percent of all adults with autism spectrum disorder. Most of them are not severely affected but a few exhibit stupor and severe excitement, which is the most extreme form of the disorder. Full expression of excitement could be a sign of comorbid Bipolar disorder but more research is needed.
More than 40 symptoms has been identified to be a result of the disorder, but some of the symptoms overlap with those of autism spectrum disorder, making diagnosing difficult even for a seasoned professional. In a few cases stupor and hyperactivity can continue for weeks or even months.
During the excitement phase individuals show combativeness and can have delusions and hallucinations and can also pose a danger to themselves or others and can make marked destruction of property..In the later stages of medium and even more in the severe and if left untreatead lethal state they will also experience autonomic instability! (Behav Sci (Basel). 2015 Dec; 5(4): 576–588.
Published online 2015 Dec 9. doi: 10.3390/bs5040576
Childhood schizophrenia increases the risk for autistic catatonia later in life dramatically. There seems to be a common font of brain pathology for psychosis, catatonia and autism.
A chronic, often debilitating neurological disorder characterized by recurrent moderate to severe headaches, often in association with a number of autonomic nervous system symptoms.
Parkinson's disease, or PD, is a progressive illness of the nervous system. Caused by the death of dopamine-producing brain cells that affect motor skills and speech. Symptoms may include bradykinesia (slow physical movement), muscle rigidity, and tremors. Behavior, thinking, sensation disorders, and the sometimes co-morbid skin condition Seborrheic dermatitis are just some of PD's numerous nonmotor symptoms. Parkinson's disease, Attention deficit/hyperactivity disorder (ADHD) & Bi-polar disorder, all appear to have some connection to one another, as all three nervous system disorders involve lower than normal levels of the brain chemical dopamine(In ADHD, Parkinson's, & the depressive phase of Bi-polar disorder.) or too much dopamine (in Mania or Manic states of Bi-polar disorder) in different areas of the brain: