Alcohol Withdrawal Presenting with Catatonia Followed by Delirium Tremens: A Clinical Case Report

This case report of a 28-year-old male with 10 years of heavy alcohol use, meeting ICD-11 criteria for Alcohol Dependence, who developed withdrawal symptoms after 72 hours of abstinence, progressing to acute catatonia. He presented with mutism, posturing, waxy flexibility, negativism, mask-like facies, poor intake, and tremors, with a Bush–Francis Catatonia Rating Scale (BFCRS) score of 28/69 and Alcohol Use Disorders Identification Test (AUDIT) score of 32/40. Injection of lorazepam led to rapid and complete resolution of catatonia, followed by the onset of delirium tremens within one hour, which was successfully managed with benzodiazepines, hydration, thiamine, and supportive care. Symptoms fully resolved within 48 hours of admission. This case highlights the importance of recognizing catatonia as a rare presentation of alcohol withdrawal and the effectiveness of prompt benzodiazepine therapy.