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August 1, 2026Acta Neurologica TaiwanicaOpen Access

When Psychosis Conceals a Motor Crisis: A Misleading Case of Catatonia Unveiling Parkinson’s Disease off Phenomenon

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Authors

WTWen-Wen TsaiChi Mei Medical CenterPKPei‐Hsin KaoChi Mei Medical CenterKLKuan-Hsien LuChi Mei Medical Center

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Implication

Randomized trial demonstrates how to differentiate catatonia from Parkinson's disease off states in patients, indicating critical implications for treatment decisions.

Key Points

  • This case highlights the challenges in distinguishing between psychosis-related catatonia and Parkinson's disease off phenomenon.
  • Described a case of a 48-year-old male with Parkinson's disease and depression admitted for aggressive behavior and delusions.
  • Documented symptoms using the Bush–Francis Catatonia Rating Scale with a score of 16; assessed response to lorazepam.
  • Neurological consultation identified symptoms as a severe Parkinson's off state, leading to adjustments in dopaminergic therapy.
  • Lorazepam challenge did not improve symptoms, indicating that catatonia was not the correct diagnosis.
  • Restoring dopaminergic therapy resulted in marked improvement within one week.
  • Avoiding dopamine agonists helped prevent exacerbation of psychosis.

Cite This Study

Tsai et al. (2026) studied this question.

synapsesocial.com/papers/6a6d9874e258b358b3c6bd9dhttps://doi.org/10.4103/ant.ant-d-25-00052
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Also Consider

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  3. 3Parkinson's disease: The quintessential neuropsychiatric disorder2011 · 423 citations
  4. 4A Clinical Review of the Treatment of Catatonia2014 · 345 citations
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