Case Presentation A 68-year-old woman with a medical history of type 2 diabetes mellitus, hypertension, dyslipidemia, hypothyroidism, sinus bradycardia with permanent pacemaker implantation, and prior bioprosthetic aortic valve replacement presented with progressive neuropsychiatric symptoms. Initial Clinical Symptoms The patient developed insidious behavioral and cognitive changes over several weeks Early symptoms included disorientation, impaired attention, psychomotor slowing, reduced spontaneous speech, and social withdrawal Progression of Neuropsychiatric Manifestations Symptoms progressed to include paranoid ideation, auditory hallucinations, emotional blunting, and mutism The patient later developed fluctuating consciousness, rigidity, immobility, negativism, and reduced oral intake, raising concern for a catatonic syndrome Physical and Neurological Examination On admission, the…