Core features of catatonia and malignant catatonia
Catatonia is a peculiar syndrome of seemingly opposite features such as
- severe psychomotor retardation (stupor) or agitation;
- excessive and strange activity such as grimacing, odd mannerisms;
- repetitive, nongoal-directed stereotypies;
- maintenance of postures spontaneously (posturing), or with passive induction (catalepsy) that may be altered even with resistance from the examiner (waxy flexibility), or resisted with equal and opposite force (gegenhalten);
- or withdrawal from interaction (negativism) or communication (mutism), or the mimicking of movements or speech (echopraxia and echolalia).
- Catatonia is denoted as malignant when autonomic lability (fever, widely variable heart rate or blood pressure) is present.
