Revisiting kahlbaum syndrome in older adults

Catatonia is a constellation of neuropsychiatric symptoms including cognitive, behavioral, motor, and affective due to medical, neurological, psychiatric illnesses, or withdrawal of medications. Catatonia is understudied in an older population, despite its higher prevalence and there are high chances of medical or neurological causes of catatonia and further complications. The available literature on catatonia in older adults reports neurological, medical illnesses, and psychiatric illnesses as common causes. The affective disorder is the most common cause amongst psychiatric illnesses and abundant literature is available on catatonia in affective disorders and psychotic disorders but there is a paucity of literature on catatonia in other common conditions like anxiety disorders and delirium, especially in older adults. Here we are reporting interesting case series of catatonia with extreme variations in presentations and course of illness. One with Generalized anxiety disorder and the other with delirium superimposed on dementia. Out of which patient with an anxiety disorder had a positive lorazepam challenge test while a patient with delirium superimposed on dementia was negative. Patients with Generalized anxiety disorder improved on Tablet Escitalopram 20mg and Tablet lorazepam 2mg per day, but patients with delirium superimposed on dementia did not improve significantly.