Catatonia With Mood and Psychotic Features in an Adolescent With Intellectual Disability and Epilepsy

Authors

  • Tiago Soares Child and Adolescent Psychiatry Department, Unidade Local de Saúde Lisboa Ocidental https://orcid.org/0009-0008-7857-4051
  • Débora Stolnik Child and Adolescent Psychiatry Department, Unidade Local de Saúde Tâmega e Sousa https://orcid.org/0009-0007-4776-738X
  • Ana Rita Rodrigues Adolescent Psychiatry Department, Unidade Local de Saúde Santo António
  • João Paulo Guerra Adolescent Psychiatry Department, Unidade Local de Saúde Santo António https://orcid.org/0000-0001-9630-7282

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v35.i3.42453

Keywords:

adolescent, catatonia, epilepsy, intellectual disability, mood disorders, psychotic disorders

Abstract

We present the case of a 15-year-old girl with moderate intellectual disability and epilepsy secondary to mesial temporal sclerosis who developed catatonia during a severe mood episode with psychotic features.
Her clinical course was marked by sudden behavioural regression, mutism, motor rigidity and insomnia, requiring inpatient psychiatric admission. After partial remission, she was discharged but relapsed two weeks later with worsening catatonia, urinary incontinence, gait disturbance and behavioural disorganisation, prompting further investigation and readmission.
The overlap between neurological, developmental and psychiatric symptoms posed diagnostic challenges, especially in distinguishing catatonia from seizure-related or medication-induced phenomena. Treatment included benzodiazepines, antipsychotic adjustments and mood stabilisers, with close monitoring of neurological comorbidities. Clinical improvement followed the introduction of lorazepam and replacement of risperidone with aripiprazole.
This case illustrates the complexity of catatonic psychosis in adolescents with neurodevelopmental and epileptic comorbidities, highlighting the importance of early recognition, tailored pharmacological intervention and multidisciplinary collaboration.

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References

Wilcox JA, Reid Duffy P. The syndrome of catatonia. Behav Sci (Basel) 2015; 5(4): 576–88. https://doi.org/10.3390/bs5040576.

Sienaert P, Dhossche DM, Vancampfort D, De Hert M, Gazdag G. A clinical review of the treatment of catatonia. Front Psychiatry 2014; 5: 181. https://doi.org/10.3389/fpsyt.2014.00181.

Consoli A, Raffin M, Laurent C, et al. Medical and developmental risk factors of catatonia in children and adolescents: a prospective case-control study. Schizophr Res 2012; 137(1–3): 151–58. https://doi.org/10.1016/j.schres.2012.02.012.

Kanner AM. Psychiatric comorbidities in epilepsy: should they be considered in the classification of epileptic disorders? Epilepsy Behav 2016; 64: 306–8. https://doi.org/10.1016/j.yebeh.2016.06.040.

Emerson E. Prevalence of psychiatric disorders in children and adolescents with and without intellectual disability. J Intellect Disabil Res 2003; 47(Pt 1): 51–8. https://doi.org/10.1046/j.1365-2788.2003.00464.x.

Moore S, Amatya DN, Chu MM, Besterman AD. Catatonia in autism and other neurodevelopmental disabilities: a state-of-the-art review. NPJ Ment Health Res 2022;1: 12. https://doi.org/10.1038/s44184-022-00012-9.

Helmstaedter C, Witt JA. Epilepsy and cognition – a bidirectional relationship? Seizure 2017; 49: 83–9. https://doi.org/10.1016/j.seizure.2017.02.017.

Bush G, Fink M, Petrides G, Dowling F, Francis A. Catatonia. I. Rating scale and standardized examination. Acta Psychiatr Scand 1996; 93(2): 129–36. https://doi.org/10.1111/j.1600-0447.1996.tb09814.x.

Kanner AM, Rivas-Grajales AM. Psychosis of epilepsy: a multifaceted neuropsychiatric disorder. CNS Spectr 2016; 21(3): 247–57. https://doi.org/10.1017/S1092852916000250.

Brugger F, Bhatia KP, Besag FM. Valproate-associated parkinsonism: a critical review of the literature. CNS Drugs 2016; 30(6): 527–40. https://doi.org/10.1007/s40263-016-0341-8.

Zhu LN, Chen D, Tan G, et al. The tolerability and safety profile of eslicarbazepine acetate in neurological disorders. J Neurol Sci 2020; 413: 116772. https://doi.org/10.1016/j.jns.2020.116772.

Pennell PB. Hormonal aspects of epilepsy. Neurol Clin 2009; 27(4): 941–65. https://doi.org/10.1016/j.ncl.2009.08.005.

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Published

2026-10-12

How to Cite

1.
Soares T, Stolnik D, Rodrigues AR, Guerra JP. Catatonia With Mood and Psychotic Features in an Adolescent With Intellectual Disability and Epilepsy. BGMJ [Internet]. 2026 Oct. 12 [cited 2026 Oct. 15];35(3):151-5. Available from: https://revistas.rcaap.pt/bgmj/article/view/42453

Issue

Vol. 35 No. 3 (2026)

Section

Clinical Case Reports

License

Copyright (c) 2026 Tiago Soares, Débora Stolnik, Ana Rita Rodrigues, João Paulo Guerra

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