A 2026 case described improvement in catatonia after lorazepam despite persistent cardiac disease and a later stroke. Improvement in one syndrome did not establish resolution of the patient’s other risks.
The coexisting physical illness
Fujiwara and colleagues reported a 71-year-old woman with catatonia, Takotsubo cardiomyopathy, an intraventricular thrombus, and deep vein thrombosis. The cardiac and thrombotic abnormalities were identified during her evaluation and treated.
A lorazepam challenge was followed by improvement in immobility and mutism, and the patient continued lorazepam. She could take meals and medication. On the fifth hospital day, however, she developed right hemiplegia and aphasia, with imaging showing extensive cerebral infarction.
A positive response has a limited scope
The authors attributed the stroke to cardiac thromboembolism in the context of the documented ventricular thrombus. The case does not identify lorazepam as the cause of the infarction or establish that improved communication eliminated the existing physical illness.
Although cardiac function later normalized, substantial neurological deficits remained. Different components of the patient’s condition therefore followed different trajectories. A summary saying only that she responded to lorazepam would omit the major continuing medical problem.
What the case contributes
The report highlights assessment difficulties when psychiatric symptoms limit communication. A treatment response can support clinical management without excluding a simultaneous cardiopulmonary or thrombotic disorder.
A single case cannot establish the frequency of Takotsubo complications in catatonia, compare anticoagulation approaches, or quantify benzodiazepine benefit. Its useful forensic lesson is to preserve the full chronology and distinguish symptom response from resolution of the risks already established by objective findings.
Source
Based on the supplied paper: Cardiogenic cerebral infarction after Takotsubo cardiomyopathy in a patient with catatonia A case re. PMC12783909.
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