Frontiers in Psychiatry (Oct 2021)

Case Report: “Niemann-Pick Disease Type C in a Catatonic Patient Treated With Electroconvulsive Therapy”

  • M. van Verseveld,
  • L. H. Koens,
  • L. H. Koens,
  • Tom J. de Koning,
  • Tom J. de Koning,
  • Tom J. de Koning,
  • R. L. E. Derikx,
  • J. A. van Waarde

DOI
https://doi.org/10.3389/fpsyt.2021.745734
Journal volume & issue
Vol. 12

Abstract

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We describe a case of an adolescent male with Niemann-Pick Type C (NP-C), a neurodegenerative lysosomal lipid storage disorder, who presented with recurrent catatonia which required repeated treatment with electroconvulsive therapy (ECT). During the ECT-course, seizure threshold increased substantially, leading to questions about the influence of NP-C on neuronal excitability. In this exemplary ECT-patient, NP-C was diagnosed not until after the first ECT-course when initial psychopharmacology for catatonia had failed and antipsychotics and benzodiazepines showed significant side-effects. Clinicians should be aware of NP-C in patients referred for ECT, especially in the case of treatment resistance, neurological symptoms and intolerance of psychopharmacological drugs. As was shown in our NP-C patient, ECT can be repeatedly effective for catatonic features. In the literature, effectiveness of ECT in patients with NP-C has sparsely been reported. This case demonstrates that detection of NP-C is beneficial for patients because more optimal treatment with ECT can be provided earlier without further exposure to side-effects.

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