A case of catalepsy after multiple cerebral infarctions

Abstract

Reports of stroke‐related catalepsy and other catatonia syndromes are rare. A 68‐year‐old man was admitted to a local hospital 10 days prior for heart failure. He subsequently developed multiple cerebral infarctions and was referred to our hospital for emergency care. He spontaneously opened his eyes but did not speak. He had hemiparesis on the right side. Diffusion‐weighted imaging revealed high‐intensity areas in the left frontal and parietal lobes and right cerebellar hemisphere. Rehabilitation therapy was initiated in the acute stage. When he was instructed to raise his left upper limb 90°, he maintained the posture for more than 5 min. We hypothesized that catatonia syndromes, including catalepsy, were caused by damage to the orbitofrontal, premotor, supplementary motor cortices, and basal forebrain. These abnormalities disappeared after 4 months. Catalepsy may also be observed in organic central nervous system diseases, such as stroke, and should be considered in stroke care.