Periodic catatonia. In 1908, Kraepelin described a form of periodic catatonia, with rapid shifts from excitement to stupor.
(22) Many patients recover completely after a single episode, while relapse after remission occurs repeatedly in periodic catatonia, which involves chronic alternating stupor and excitement waxing and waning over years.
Periodic catatonia refers to recurrent, brief hypokinetic or hyperkinetic episodes lasting 4 to 10 days
The DSM5's unspecified catatonia probably reflects two overlapping concepts: idiopathic recurrent catatonia from psychiatry in the English-speaking world  and periodic catatonia from continental European psychiatry.
Periodic Catatonia. Kraepelin and two other lesser known Europeans, Gjessing and Leonhard, are associated with the concept of periodic catatonia.
Biological Abnormalities in Periodic Catatonia. Rolv Gjessing  made many biological observations of patients with periodic catatonia, but he focused on abnormalities in nitrogen metabolism.
The clinical description of familial periodic catatonia by Leonard and his disciples  is more cohesive and understandable in a contemporary context.
Table 1 describes adrenal abnormalities in 8 published patients with periodic catatonia [30-36].
As far as we can tell, the literature describes no cases of patients with periodic catatonia in whom the onset of menses was associated with the onset of catatonia.
Our case represents the only example of periodic catatonia specifically exacerbated by the menses.
Leonhard  and his followers in Germany [25-27] described periodic catatonia as a familial disorder; our patient probably had a form of familial periodic catatonia.
We have presented years of clinical observations and drawn from hundreds of biological measurements in a patient with familial periodic catatonia. This case may have implications for those patients with (1) familial periodic catatonia, (2) fear as a salient feature of catatonia, and (3) any type of catatonia.