Diagnostic Challenge of Primary Psychiatric Catatonia Versus Seronegative Autoimmune Encephalitis in Pediatrics: A Case Report
- 1Pediatrics, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
- 2Pediatrics and Child Health, Rush University, Chicago, USA
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.
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BibTeX
@article{ohabuenyi2026diagnostic,
title = {{Diagnostic Challenge of Primary Psychiatric Catatonia Versus Seronegative Autoimmune Encephalitis in Pediatrics: A Case Report}},
author = {Sandra Ohabuenyi and Charita Kunta and Kingsley Udom and Neha Bhagi and Delete Ebere-Bank},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117105},
url = {https://europepmc.org/article/PMC/PMC13716875},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diagnostic Challenge of Primary Psychiatric Catatonia Versus Seronegative Autoimmune Encephalitis in Pediatrics: A Case Report
AU - Sandra Ohabuenyi
AU - Charita Kunta
AU - Kingsley Udom
AU - Neha Bhagi
AU - Delete Ebere-Bank
PY - 2026
DA - 2026/09/28
JO - Cureus
DO - 10.7759/cureus.117105
UR - https://europepmc.org/article/PMC/PMC13716875
AB - 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.
SN - 2168-8184
ER -