# Isolated Catatonia as a Rare Initial Manifestation of Moyamoya Disease

## TL;DR

A rare case of Moyamoya disease presented initially with isolated catatonia, highlighting the need for careful neurological evaluation in psychiatric-like symptoms.

## Contribution

This paper presents a rare case linking isolated catatonia with Moyamoya disease, emphasizing the importance of neuroimaging in atypical psychiatric presentations.

## Key findings

- Isolated catatonia can be an initial manifestation of Moyamoya disease.
- Neuroimaging is crucial for diagnosing Moyamoya disease in psychiatric-like presentations.
- Psychiatric symptoms in Moyamoya disease may be mistaken for primary psychiatric disorders.

## Abstract

Moyamoya disease (MMD) is a rare, idiopathic, and life-threatening cerebrovascular disorder characterized by progressive stenosis and occlusion of the intracranial internal carotid arteries, leading to the formation of abnormal collateral vessels. The incidence of MMD is high in Asian countries but has also been reported in other regions with lower prevalence. Clinically, the disease can manifest with ischemic, hemorrhagic, or epileptic symptoms. Psychiatric manifestations are atypical and may be mistaken for primary psychiatric disorders, necessitating a specialized approach to management. We report a rare clinical case of a patient who was admitted with isolated catatonia and was diagnosed with MMD through neuroimaging. We discuss the possible mechanisms underlying this association, radiological findings, and strategies for managing such an uncommon presentation.