When Burns Lead to Silence: Catatonia a Case Report

Catatonia is a severe neuropsychiatric syndrome marked by disturbances in motor function, mood, and behavior, commonly presenting with symptoms such as rigidity, mutism, posturing, and autonomic instability.1 Once regarded solely as a subtype of schizophrenia, catatonia is now recognized across a broad range of medical and neurological conditions.2 Its most dangerous form, malignant catatonia (MC), is characterized by profound autonomic dysregulation, altered mental status, and multi-organ failure.3,4 When unrecognized or misdiagnosed, particularly outside psychiatric settings, MC can progress rapidly and result in death.5 Although mostly described in the contexts of psychiatry and ICU medicine, catatonia’s occurrence in patients with burn injuries is underreported and poorly understood.6 Whether this represents the true rarity of the syndrome or its underdiagnosis remains unclear. Furthermore, burns are a significant physiological stressor that induce a systemic inflammatory response, leading to a range of neuropsychiatric sequelae, particularly in vulnerable patients. Catatonic symptoms in burn units can be obscured by delirium, pain, or sedation leading to the underdiagnosis of this syndrome.7