Severe Medical and Neurologic Complications Associated with Near-Lethal Catatonia Treated with Electroconvulsive Therapy.

In a patient with near-lethal catatonia, complications progressed from mild fever and tachycardia to severe hyperthermia, malignant hypertension, and cortical and subcortical dysfunction with increased urine cortisol and catecholamine concentrations, bilateral extensor toe reflexes, decerebrate posturing, and Cheyne-Stokes respirations. Electroconvulsive treatment reversed these changes and prevented almost certain death.