IMGENES EN MEDICINA / IMAGES IN MEDICINE

Catatonia: ese soslayado sndrome.

Catatonia: an overlooked syndrome.
Lizardo Cruzado1a, Lucy Chang-Torres,1,2,b, Humberto Maldonado-Ruz1,3b.

La catatonia es un sndrome an misterioso en la medicina actual: incluye anomalas

motoras y de la voluntad, psicolgicamente incomprensibles, que abarcan desde el
mutismo, negativismo y catalepsia hasta la agitacin ms extrema e inmotivada, aunque
se han descrito hasta cuarenta signos semiolgicos. Errneamente se la crey sinnimo
de esquizofrenia pero la evidencia ha demostrado que la mayora de pacientes
catatnicos sufren trastornos afectivos o patologas mdicas y neurolgicas diversas.
Esto es, la catatonia, anlogamente al delirium, es un sndrome internosolgico, muchas
veces mal diagnosticado. El empleo de antipsicticos empeora el cuadro. En las
imgenes: mujer de 18 aos con trastorno bipolar y episodio depresivo catatnico, quien
se halla en estupor catalptico, el cual mejor con uso de benzodiacepinas -el
tratamiento farmacolgico de eleccin-.

Catatonia is still a mysterious syndrome in modern medicine: it includes

psychologically incomprehensible motor and volitive anomalies, ranging from mutism,
negativism and catalepsy to the most extreme and unmotivated agitation, even when
almost forty semiological signs have been described. It was erroneously believed that
catatonia is synonymous with schizophrenia but evidence now has shown that most
catatonic patients have affective disorders or various medical and neurological diseases.
That is to say that catatonia, as well as delirium, is an internosological syndrome often
misdiagnosed. The use of antipsychotics worsens the disorder. In the pictures, an 18year-old woman with bipolar disorder and catatonic depressive episode is going through
cataleptic stupor, which was improved with benzodiazepines use -the pharmacological
treatment of choice-.

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1 Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi.
2 Universidad Nacional Mayor de San Marcos.
3 Universidad Peruana Cayetano Heredia.
a Psiquiatra.
b Mdico residente de Psiquiatra