Benzodiazepine withdrawal delirium with catatonic features. Occurrence in patients with partial seizure disorders

Arch Neurol. 1989 Jun;46(6):696-9. doi: 10.1001/archneur.1989.00520420118033.

Abstract

We report the cases of 3 patients with medically intractable seizures in whom withdrawal of treatment with a long-acting benzodiazepine (clorazepate dipotassium, 2 patients; clonazepam, 1 patient) was followed by delirium with catatoniclike features. While an increase in seizure frequency occurred during withdrawal and prior to the onset of behavioral changes, electroencephalograms did not show epileptiform activity during the delirium. We compared these 3 patients with 10 others with intractable seizures in whom antiepileptic therapy was withdrawn without subsequent behavior changes. High-dose benzodiazepine therapy and a history of viral encephalitis may be risk factors for withdrawal delirium.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Benzodiazepines / adverse effects*
  • Benzodiazepines / therapeutic use
  • Catatonia / chemically induced*
  • Clonazepam / adverse effects
  • Clorazepate Dipotassium / adverse effects
  • Delirium / chemically induced*
  • Encephalitis / complications
  • Encephalitis / etiology
  • Female
  • Humans
  • Male
  • Seizures / drug therapy*
  • Seizures / etiology
  • Substance Withdrawal Syndrome*
  • Virus Diseases

Substances

  • Benzodiazepines
  • Clonazepam
  • Clorazepate Dipotassium