Chronic catatonia with obsessive compulsive disorder symptoms treated with lorazepam, memantine, aripiprazole, fluvoxamine and neurosurgery.

Catatonia is a syndrome with protean manifestations and multiple aetiologies. In this report, the authors describe the case of a young woman who presented for care after a 13-year period of catatonia-like symptoms, including mutism, refusal to eat and persistent neck flexion. Medical management included placement of a percutaneous endoscopic gastric tube for nutritional support. A thorough medical investigation later revealed the presence of a cervical spine haemangioma that was treated surgically, with improvement in neck posturing. Psychopharmacological treatment included lorazepam, aripiprazole and memantine. Addition of fluvoxamine to target obsessive compulsive disorder (OCD)-like symptoms resulted in clinical improvement, suggesting OCD as a possible cause of this patient's chronic catatonic state.