Work

Diagnostic Challenge of Primary Psychiatric Catatonia Versus Seronegative Autoimmune Encephalitis in Pediatrics: A Case Report

Year: 2026

Type: article

Abstract: Catatonia in adolescents presents a diagnostic challenge when autoimmune and psychiatric etiologies overlap. We describe a 16-year-old male with recurrent severe catatonia, complete mutism, and functional decline over four months. Despite a comprehensive negative autoimmune workup, inflammatory markers (elevated interleukin-2 receptor) and clinical features suggested seronegative autoimmune encephalitis. The patient required high-dose lorazepam (18 milligrams per day) and received empiric immunotherapy with intravenous immunoglobulin and corticosteroids, followed by enrollment in a specialized electroconvulsive therapy program. He demonstrated substantial improvement with the return of bilingual speech and social interaction. This case illustrates the importance of maintaining a broad differential diagnosis in adolescent catatonia and considering empiric immunotherapy when clinical suspicion for autoimmune etiology remains high despite negative antibody testing.

Source: Cureus

DOI: 10.7759/cureus.117105

Authors: Sandra Ohabuenyi, Charita Kunta, Kingsley Udom, Neha Bhagi, Delete Ebere-Bank

Institutions: John H. Stroger, Jr. Hospital of Cook County, Rush University

Language: English

Topic: Electroconvulsive Therapy Studies

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7214796216