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Suppression of Catatonia-Like Signs by Lorazepam in Nonconvulsive Status Epilepticus Without Seizure Termination

Received July 14, 2000; revised November 6, 2000; accepted November 22, 2000. From the Department of Psychiatry, Southern Illinois University School of Medicine, Springfield, IL (CMS, KMB), and the William S. Hall Psychiatric Institute, University of South Carolina, Columbia, SC (LSS). Address correspondence to Conrad M. Swartz, Ph.D., M.D., Department of Psychiatry, Southern Illinois University, P.O. Box 19642, Springfield, IL 62794-9642. e-mail: ectdoc{at}pol.net

Nonconvulsive status epilepticus (NCSE) cannot be reliably distinguished from catatonia by signs or symptoms. The authors report on a 68-year-old man with endogenous major depression who displayed catatonia-like psychopathology, which temporarily disappeared with lorazepam. An EEG then revealed NCSE. Presumably, lorazepam suppressed seizure in areas where it had caused clouding of consciousness, but it did not suppress all seizure activity. When lorazepam was stopped, the catatonia-like delirium returned; it disappeared again with valproate administration. This case illustrates that the reduction of signs consistent with catatonia by benzodiazepines does not by itself confirm catatonia, even in patients with endogenous depression.

Key Words: Epilepsy • Lorazepam • Catatonia

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