By Danielle W. Lowe, MD, PhD
Catatonia is increasingly recognized as a comorbid condition in neurodevelopmental populations with some estimates of 10% prevalence in Autism (1). A pediatric catatonia clinical assessment and treatment pathway was published this year (2) and highlighted the use of the Pediatric Catatonia Rating Scale (PCRS) as an alternative to the Bush-Francis Catatonia Rating Scale (BFCRS) in minors (3). Autism specific catatonia scales (4) or other catatonia scales can be used in neurodivergent populations with scoring compared to a patient’s baseline function.
Electroconvulsive therapy (ECT) is the treatment of choice in minors with poor response to lorazepam, symptoms of malignant catatonia, or 72 hours of poor oral intake (4). While there are many barriers for ECT in minors due to state regulations and access to care, ECT is well tolerated in minors and neurodivergent patients to stabilize catatonia symptoms.
