KATALEPSY

From Big Medical Encyclopedia

KATALEPSY (Greek katalepsis skhvatyvaniye, attack; synonym wax flexibility) — the frustration in the motive sphere which is expressed in long preservation by separate parts of a body of the patient (the head, hands, legs) of the situation given them characteristic of a catatonic stupor. The patient can is long to hold difficult, inconvenient poses.

A clinical picture

At To. muscles show plastic resistance to the passive movements and as they soft wax, stiffen in this or that situation given them. The feeling of fatigue at the same time is absent, and parts of a body adopt the initial provision under the influence of own weight.

Develops To. most often gradually, extending consistently from muscles of a neck and upper extremities to muscles of the lower extremities. Its involution goes in an opposite direction. To. can be both skoroprokhodyashchy frustration, and remaining for a long time (weeks, months).

To. it is not found at a stupor with the phenomena of negativism when the patient shows resistance to any attempt to change position of his body, and also at a stupor with muscular catalepsy.

V. P. Serbsky (1912) along with expressed To. spoke about special kataleptoidny states which are observed at the most initial stage of the developing catatonic stupor (see. Catatonic syndrome ), when wax flexibility is expressed not enough and the patient as if randomly of a sokhr nyat the situation given it. Their short duration is characteristic of these states.

Most often To. meets at schizophrenia, sometimes at hysterical psychoses.

A pathogeny

there are two various points of view on an origin To. — neurologic and psychological. Supporters of the first note interest of certain formations of a brain in development To., and supporters of the second give it purely psikhol, an explanation. So, E. Krepelin (1909) said that an origin To. it is connected with the raised strong-willed podchinyaemost. I. P. Pavlov considered that To. has fiziol, the nature. This thought gained further development in A. G. Ivanov-Smolensk researches. In a basis To. the isolated switching off of a cerebral cortex with safe activity of underlying departments of the nervous motive device lies. Major importance of this activity — an equilibration of a body and its parts in space, however in a usual state it is disguised by autokinesias. At To. as a result of switching off of influence of bark this uravnoveshivatelny reflex comes to light openly and sharply.

The diagnosis

Existence To. in an overall picture of a catatonic stupor easily is defined in connection with its idiosyncrasies. The frustration reminding To., are observed at a hysterical stupor. The hysterical stupor arises suddenly more often, and, unlike a catatonic stupor with the phenomena To., it has a clear psychogenic origin. Its emergence is preceded by disorders, sometimes a hysterics; disappearance is followed by rough affective manifestations. Suddenly arising hysterical stupor, finding the patient in a certain pose, fixes it. So, e.g., the patient stiffens at the time of the conversation with the doctor which he just carried on, vigorously gesticulating. The designated wax flexibility allows to give to the patient any new situation. However quite often muscular tension increases so that two persons can lift the patient, holding it only by a nape and by heels. Conditions of a hysterical stupor with the phenomena similar on To., can proceed up to several days.

The known looking alike To. represent motive frustration at some organic lesions of a brain, napr, at parkinsonism (see), caused by epidemic encephalitis. Such frustration arise always accompanied by other disturbances inherent to parkinsonism, and have steady character.

Treatment is defined by a basic disease.

Forecast depends on features and character of a current of a catatonia.


Bibliography: Ivanov-Smolensk A. G. Sketches of neurodynamic psychiatry, M., 1974, bibliogr.; Pavlov I. P. Complete works, t. 3, book 1, page 346, M.-L., 1951; Serbian V. P. The forms of a mental disorder described under the name of catatonias, M., 1890, bibliogr.: P about about t A. Manuel of alphab£ti (jue de psychiatrie, p. 108, P., 1965.

D. S. Ozeretskovsky.

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