Aušra Bagdonaitė, Aldona Šiurkutė, Gintaras Naujokas

Abstract

Objective: The authors, reviewing the clinical and treatment controversies, illustrate the effectiveness of haloperidol for the patient who developed organic catatonia together with impairment of consciousness, complex focal seizures and myoclonus and suffering from paraneoplastic encephalomyelitis.
Method – a clinical case description.
Results. A sixty-nine-year-old man was hospitalized in the Republican Vilnius Psychiatric hospital because of disturbance of consciousness with catatonic symptoms. Conditions became worse, epileptic seizures continued, postictal catatonic stupor and later epileptic condition developed. Psychosis disappeared while treating with haloperidol, and no adverse effect was observed. When antiepileptic treatment was corrected, the continuation of antipsychotics was not necessary.
Conclusions: When catatonic symptoms appear on symptomatic psychoses, conditions worsen and require urgent specification and correction of the treatment. It is very difficult to select antipsychotic medication when several severe conditions are present (catatonia, delirium, epileptic seizures, status epilepticus, myoclonus). It is very important to choose an antipsychotic which eliminates psychotic symptoms, has lowest risk to trigger epileptic seizures and to consider its interaction with antiepileptic drugs when picking its dose. In our case it was haloperidol.

Article in Lithuanian

doi:10.5200/sm-hs.2012.008

Keyword(s): haloperidol; carbamazepine; myoclonus; organic; catatonia; symptomatic psychoses; paraneoplastic encephalomyelitis; epileptic attacks
DOI: 10.5200/249
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