A child improved during a lengthy course after cyclosporine was stopped and psychiatric treatment introduced. The sequence did not isolate lorazepam’s independent effect.
A nine-year-old with nephrotic syndrome developed mutism, posturing, gait changes, insomnia, and delusional symptoms. A markedly elevated cyclosporine concentration had been documented before admission.
Cyclosporine was discontinued. A transient response to propofol was described, followed by lorazepam and later quetiapine. Symptoms resolved, and both psychiatric medicines were eventually tapered without recurrence over the reported follow-up.
The authors attributed the syndrome to cyclosporine-related neurotoxicity, but a single case cannot establish a concentration threshold or mechanism for every patient. Resolution could involve withdrawal of the suspected cause, ongoing treatment, and time.
The report does not show that lorazepam alone produced recovery or that propofol’s brief response predicted a sustained outcome. It illustrates why exposure history, treatment chronology, motor signs, psychosis, and longer follow-up should be recorded separately in a suspected medication-associated catatonia case.
Original analysis of the supplied journal article, identified as PMC6480487.