Catatonic schizophrenia (F20.2 according to ICD-10) is a form of schizophrenia in which a complex of mental and musculo-motor disorders is observed .
Symptoms of catatonic schizophrenia
- Catatonic stupor – a condition where the patient is in one, and that is “a frozen state” in for hours and even many days. Sometimes, with prolonged immobility, this condition can contribute to compression of the soft tissues of the limbs with nerve damage.
- Catatonic excitation e – sudden, unfocused, unmotivated actions, often of a destructive nature. May alternate with catatonic stupor.
- Wax flexibility is a condition in which the patient does not resist if the position of the patient and his limbs is changed from the outside. If the patient’s head is lifted from the supine position on the pillow, the head will hang in the air without visible support. The so-called “flexibility of wax” occurs in the muscles due to special metabolic processes and changes in nerve signals from the brain and spinal cord. Submission to various changes in body position from the outside is an important symptom of the disease.
- Negativism . The patient resists external influences, both physical and vocal.
Types of negativism:
- active – the patient does not do what is asked of him;
- paradoxical – the patient performs directly opposite actions in comparison with those that he is offered to perform;
- passive negativism manifests itself in the patient’s lack of response to any requests (ignorance).
- Mutism . Lack of speech in the presence of all the necessary structures of the body (vocal cords, palate, tongue, etc.). Sometimes a patient with catatonic schizophrenia reacts only to a whispered speech addressed to him, and does not perceive a voice at a normal volume (Pavlov’s symptom).
- Stereotyped and paradoxical movements . The patient can shake off something for hours or perform other meaningless (automatic) actions of the same type.
Diagnostics
Diagnosis of the disease is carried out on the basis of at least one of the symptoms listed above, taking into account the fact that stupor is periodically replaced by excitement. It is necessary to distinguish (differentiate) this type of schizophrenia from encephalitis, brain tumors, and some types of epilepsy. In these cases, magnetic resonance imaging and encephalography (recording of brain biocurrents) play a decisive role .
There are several types of the disease:
- continuously relapsing (most severe),
- episodic with the achievement of persistent improvement,
- episodic with stable disorders,
- episodic with a gradual and constant progression of violations.
Treatment for catatonic schizophrenia
Therapy depends on the phase of the disease. If the patient is agitated, it is eliminated with antipsychotics (drugs with chemical formulas similar to haloperidol or chlorpromazine). For stupor, sedatives (anxiolytics), nootropics (improving blood circulation in the nervous system and the conduction of impulses in it), antipsychotics are used. The intensity of the use of drugs and their doses depend on the severity of the disease and the duration of the onset and existence of schizophrenia. In our clinic, this disease is cured successfully and quickly.