Dear Editor
We recently read an interesting case report in your Journal about the complete disappearance of catatonia after a single intravenous lorazepam challenge test in a patient with autistic features and a small meningioma.1 We would like to congratulate the authors but also point out some weaknesses of the article.
We have already seen several cases of organic catatonia,2 and we noticed the authors did not cite the latest evidence-based consensus guidelines for the treatment of catatonia.3 Therefore, we wonder if the patient diagnosed with a first episode of psychosis with autism features and anxiety-related catatonia had any changes in electroencephalography or lumbar puncture before treatment to rule out epilepsy4 or encephalitis, for example.5
Did the brain magnetic resonance imaging (MRI) with contrast also show signs of encephalitis in addition to the meningioma? How many patients worldwide are diagnosed with pseudopsychiatric catatonia without a neuropsychiatric disorder being completely ruled out?
Disclosure
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. All authors certify that they participated sufficiently in this work to take public responsibility of the content of this article, reviewed the final version of the article and approved it for publication, and the work of this article is original and has not been published and is not being considered for publication elsewhere. All authors certify that there are no affiliations with or involvement in any organization or entity that has a direct financial interest in the subject manner. None of the authors have any conflict of interest to disclose.
Footnotes
Conflicts of Interest and Source of Funding
None.
Statement of Ethical Considerations
None.
Acknowledgments
None.
Contributor Information
João Gama Marques, Gama Marques, MD, MSc, PhD, Consulta de Esquizofrenia Resistente, Hospital Júlio de Matos, Unidade Local de Saúde São José, Centro Clínico Académico de Lisboa, Lisboa, Portugal; Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Centro Académico de Medicina de Lisboa, Lisboa, Portugal..
Josef Finsterer, Finsterer, MD, PhD, Neurology Department, Neurology & Neurophysiology Center, Vienna, Austria..
References
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