Catatonia as a Presenting Symptom of Isolated Neurosarcoidosis in a Woman With Schizophrenia

Background Catatonia is a presenting sign for many primary psychiatric disorders but it can also herald medical and neurological conditions. Increasing research has highlighted co-occurrence catatonia and delirium and how this combination warrants a thorough medical workup. Case presentation We present a case of a middle-aged woman with catatonia and delirium secondary to neurosarcoidosis only involving the brain; we document her 30-day hospitalization and intensive medical work-up that eventually revealed isolated neurosarcoidosis. This is the first reported case to our knowledge in the literature of catatonia occurring due to isolated neurosarcoidosis. Conclusion For this patient, albeit with a history of schizophrenia, the presence of delirium pushed the medical team to pursue a comprehensive work up instead of relying on a psychiatric diagnosis as the explanation for her puzzling clinical presentation. This case report supports a paradigm shift for physicians to think of catatonia similar to delirium: A syndrome that results from an underlying condition that must be treated in order to resolve the catatonia.