A Case of Benign Sporadic Encephalitis Which was Initially Suggestive of Catatonic Type of Schizophrenia

Abstract

In the present communication, the auther has reported a case of atypical encephalitis which presented psychic disorders suggestive of catatonic symptoms at the onset and a benign prognosis in the end. Based on clinical features,90 days of the course would be devided into four stages; four days of prodromal stage when the patient had complained of cold in the head, six days of initial stage when she had shown psychic disorders resembling catatonic stupor,36 days of acme stage when she had continuously presented serious disturbances of consciousness such as delirium and coma, and 44 days of reconvalescence stage when she had shown emotional irritability. The patient showed a transient maniacal excitement which seemed to be of psychogenic origin right after the discharge from hospital but she was fully cured without any residual disorder after all.
When the patient was showing a catatonic stupor at the initial stage, the re were neither inflammatory nor degenerative signs in the neurological investigations and laboratory examinations. However, in reviewing the whole course of her case, the author considers that behind the psychic symptoms at the initial stage there may be a certain disturbance of consciousness, particularly an alteration of extent of consciousness rather than that of clarity of the alertness, which could be detected by some means.
EEG findings went almost abreast of clinical ones, in par ticular disturbance of alertness were apparently in pallarel with slowing of predominant activity at the acme stage. Moreover, EEG abnormality preceded the disturbance of alertness and lasted 15 months after the recoverry from it. In this regard, the author has stressed the necessity and importance of careful EEG examination in case of patients with possible disturbances of consciousness associated with psychotic syndrome.