TY - JOUR T1 - Case of paediatric catatonia precipitated by antipsychotic withdrawal in a child with autism spectrum disorder JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-240785 VL - 14 IS - 4 SP - e240785 AU - Mohd Faisal AU - Vishnu Pradeep AU - Susan O'Hanrahan Y1 - 2021/04/01 UR - http://casereports.bmj.com/content/14/4/e240785.abstract N2 - A 13-year-old girl with moderate intellectual disability and autism spectrum disorder (ASD) was admitted to the paediatric high-dependency unit following an 8-week history of altered mental status and motor behaviour. Her symptoms emerged followed shortly after discontinuation of risperidone, an atypical antipsychotic previously commenced to manage disruptive behaviour associated with ASD. On physical examination, the patient presented with negativism, grimacing, automatic obedience, waxy flexibility and ambitendency. Blood tests, neuroimaging and lumbar puncture failed to reveal an acute infectious or neurological precipitant. She responded immediately to a trial of intramuscular lorazepam titrated to a total daily dose of 12 mg. This case presents challenges of accurately diagnosing and managing catatonic symptoms in adolescent patients with ASD. We also discuss the potential risk of precipitating catatonia following the discontinuation of antipsychotic treatment that has been prescribed for a prolonged duration. ER -