Atypical Presentation of Catatonia in an Adolescent With Autism Spectrum Disorder.

This study reports on a teenage girl with autism who developed catatonia - a serious condition causing movement and behavior problems. Her symptoms looked different from typical catatonia, making it harder to diagnose. Standard treatments like anxiety medications didn't work well, which is common in autistic people with catatonia. She needed multiple hospital stays and eventually required electroconvulsive therapy (ECT) to improve.

This case report describes an adolescent female with autism spectrum disorder who presented with excited catatonia that was difficult to recognize due to atypical symptoms. The case highlights diagnostic challenges and treatment resistance commonly seen in this population. Multiple treatment approaches were attempted across several hospital admissions, including antipsychotics, lorazepam, zolpidem, and eventually electroconvulsive therapy. The authors note that catatonia prevalence in ASD populations may reach 12-18% in some studies, but research on management approaches remains limited.

The case emphasizes that catatonia in individuals with ASD tends to be less responsive to standard benzodiazepine treatment compared to neurotypical populations, requiring alternative therapeutic strategies.

Clinicians should maintain high awareness for atypical catatonia presentations in autistic individuals. Standard benzodiazepine treatments may be insufficient, requiring consideration of alternative therapies including ECT. Early recognition and specialized treatment approaches are essential given the complexity and treatment resistance often seen in this population.

This is a single case report limiting generalizability. The authors acknowledge a paucity of research on catatonia management in ASD populations. No specific outcome measures or treatment response data are provided in the abstract.

Catatonia in individuals with autism spectrum disorder (ASD) can present atypically. Symptoms of catatonia can be difficult to recognize if they are atypical, which can delay proper medical workup and treatment. Comorbid catatonia can occur in individuals with ASD, with reported prevalence rates reaching as high as 12% to 18% in certain studies. However, there is a paucity of research on the management of catatonia in this demographic group.

What evidence we currently have indicates that catatonia in individuals with ASD is less responsive to treatment with benzodiazepines than catatonia in individuals without ASD. We present the case report of an adolescent female with ASD presenting with signs of excited catatonia whose treatment spanned multiple inpatient admissions and trials of medications, including antipsychotics, lorazepam, zolpidem, and eventually electroconvulsive therapy. The complexities of treating catatonia that displays atypical symptomatology and is resistant to oral benzodiazepines are discussed.