DOWN THE MEMORY LANE

Volume 11 Issues 5 May, 2021

It was a typical day of my internship; it’s just that I was posted in psychiatry. Though, much interested in medicine and paediatrics, I deliberately opted for psychiatry posting for the sake of bunking it and to getting some time for myself.

On the first day of psychiatry posting, my co-interns and I, were introduced to a psychiatry case—a disheveled young female staring with a blank look and was apparently unable to speak for the past 15 days. Her neurological examination was grossly normal except for the presence of rigidity. The case was that of ‘catatonia’.

“Catatonia?”, I tried to recollect; the term sounded familiar to me. What could be a possible cause of the condition making this young lady so miserable all of a sudden?

My curiosity pushed me to follow up on the case; she was given electro-convulsive therapy (ECT), and after the first ECT, the patient started talking and eating. I was amazed to see the dramatic improvement in the patient.

Sadly, after the 5th day of her 2nd ECT, patient developed status epilepticus and died, leaving a painful memory in my mind.

How a normal young woman suddenly developed catatonia and died, leaving her family and children behind. What could go wrong with her? What more could’ve been done to save her?

Possibly, the case induced an interest in psychiatry, and I joined psychiatry. Years later, I happened to attend a conference on autoimmune encephalitis.

Suddenly, I found what could be the possible answers to my lingering quest; the woman could have suffered from autoimmune encephalitis! The catatonic presentation improved after ECT but she eventually developed status epilepticus. The autoimmune encephalitis diagnosis was perhaps missed!

Well…years later, when I reminisce about that lady, I know that “Catatonia” is still an enigma for psychiatry, representing the varied manifestation of the complex brain. Furthermore, the biological links for many psychiatric conditions are yet to be explored.