Objective: Catatonic syndrome, or catatonia (from other Greek κατατείνω – “stretch, strain”), is a psychopathological syndrome (a group of symptoms), the main clinical manifestation of which is movement disorders.

Background: Hyperbaric oxygen therapy (HBO) is a therapeutic and prophylactic procedure for creating conditions for the patient that facilitate the saturation of his body with oxygen. For this, the patient is placed in a special chamber, inside which an increased pressure is maintained, and the proportion of oxygen in the respiratory mixture is increased. The need for such treatment arises in any diseases and conditions accompanied by oxygen metabolism disorders, regardless of the reasons that caused them: with cardio diseases, diabetes, various intoxications, autoimmune diseases.

Method: We observed 3 patients suffered from Covid-19 caused encephalitis with NMDA receptor antibodies manifested with these symptoms. It was discovered that Covid-19 infection could cause autoimmune encephalitis (AE) with catatonia syndrome in terms of catatonic stupor or sub-stupor, catatonic excitation, mutism (silence). active or passive negativism. echolalia (repetition of the words of others), echopraxia (repetition of the actions and movements of others). Since COVID-19 pneumonia cause serious oxygen deficit, hyperbaric oxygenation (HBO) was used for treatment in 2 patients. Anti-oxydant  (mexidol) therapy applied for one patient with catatonia. Level of N-metyl-d-aspartat receptor (NMDAR) antibodies using Western blot analysis and PCR test for SARS-Cov-2 was measured in patients serum and CSF. Brain CT and MRI were studied. Interleukin 6 (IL-6) was studied only in patient’s CSF before and after the treatment.

Results: It was revealed that NMDR and IL-6 concentrations were increased in all AE patients with catatonia syndrome. Neuroimaging studies confirmed the presence of encephalitis with a predominant lesion of the basal ganglia in all examined patients. After НBO therapy these parameters improved tremendously.

Conclusion: Symptoms of many mental illnesses are caused by oxygen starvation of neurons. In this sense, the signs of catatonia resulting from AE can be corrected by HBO to a greater extent than as a result of the use of traditional antioxidant and antiviral therapy. Improvements in NMDAR and IL-6 levels support these assumptions.

References: 1. COVID-19 presenting with catatonia. Raidurg K, Wadgaonkar G, Panse S, Santre M. Ind Psychiatry J. 2021 Oct;30(Suppl 1):S334-S335. doi: 10.4103/0972-6748.328846.
2. A Case of Catatonia in a Man With COVID-19.Caan MP, Lim CT, Howard M. Psychosomatics. 2020 Sep-Oct;61(5):556-560. doi: 10.1016/j.psym.2020.05.021.
3. Hyperbaric oxygen therapy for mild traumatic brain injury persistent postconcussion syndrome: a randomized controlled trial.Harch PG, Andrews SR, Rowe CJ, Lischka JR, Townsend MH, Yu Q, Mercante DE. Med Gas Res. 2020 Jan-Mar;10(1):8-20. doi: 10.4103/2045-9912.279978.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/catatonic-syndrome-in-covid-19-infection-medication-treatment-or-hyperbaric-oxygen-therapy/