Severe medical and neurologic complications associated with near-lethal catatonic treated with electroconvulsive therapy

In a patient with near-lethal catatonia, complications progressed from mild fever and tachycardia to severe hyperthermia, malignant hypertension, and cortical and subcortical dysfunction with increased urine cortisol and catecholamine concentrations, bilateral extensor toe reflexes, decerebrate posturing, and Cheyne-Stokes respirations. Electroconvulsive treatment reversed these changes and prevented almost certain death.