This study examined the consistency of symptom profiles across episodes of catationia. A recently developed standardized examination and symptom scale systematically rates 23 motor signs of catatonia, permitting symptom analysis of recurrent illness. Patients from the emergency room or inpatient unit were prospectively examined using the 23-item Bush-Francis Catatonia Rating Scale (BFCRS), both on initial presentation and during a later episode of catatonia. Five cases were identified, with a variable interval (mean, 10.7 months; range 4.5 to 20) between episodes. All five met DSM-IV motor criteria for catatonia (293.89) and research criteria of more than two BFCRS signs. They showed a mean of 9.6 (range, 7 to 15) catatonic signs in the first episode, and 9.6 (range, 4 to 14) signs in the second. Of the 23 individual BFCRS motor signs, a mean of 16.6 (range, 13 to 21) showed agreement of signs (absence or presence) between the two episodes. The catatonic syndrome shows consistency of motor symptoms on recurrent episodes and the BFCRS facilitates the systematic study of catatonia.