Herpes Encephalitis With Catatonic Stupor

Psychiatrists must be alert to the possibility of patients with herpes encephalitis being admitted to psychiatric units, and they should be aware of the difficulties in differential diagnosis of catatonic stupor. One case history demonstrates how catatonic stupor can easily be equated with catatonic schizophrenia. The differential diagnosis of such patients requires (1) a careful study of the mental status, focusing on such cognitive functions as attention, orientation, and memory; (2) examination of the pupils, eye movements, respiration rate, and motor movements; and (3) amobarbital (Amytal) interview and possible electroencephalogram. Further work-up is best performed by the neurologist.