Disuse Left Hand Atrophy and Persistent Left Clenched Fist in an Adult with Catatonic Schizophrenia

S. Hamed
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Abstract

Case description: A 34-year-old male had schizophrenia characterized (in severe episodes) by apathy, negativism and auditory hallucinations. He had low intelligence (IQ = 68), schizoid personality traits and first degree relatives with schizophrenia. At the age of 27, he experienced stereotyped spitting behavior, bizarre facial grimacing and left persistent clenched fist posturing. Neurological evaluation revealed left hand posturing, atrophy and nail injuries of the hand flesh with fungal infection and motor apraxia. Therapy with different antipsychotics, electroconvulsive therapy and lorazepam resulted in partial clinical improvement but failed to improve hand posturing.
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成人紧张性精神分裂症患者的废用性左手萎缩和持续性左握拳
病例描述:一名34岁男性精神分裂症患者(严重发作时)表现为冷漠、消极和幻听。他智力低下(IQ = 68),精神分裂人格特征,一级亲属患有精神分裂症。27岁时,他经历了刻板的吐痰行为、奇怪的鬼脸和持续的握拳姿势。神经学评估显示左手姿势,手部肌肉萎缩和指甲损伤,伴有真菌感染和运动失用症。采用不同抗精神病药物、电惊厥治疗和劳拉西泮治疗可部分改善临床症状,但未能改善手部姿势。
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