Catatonia and Dementia

2016 ◽  
Vol 33 (S1) ◽  
pp. S467-S467
Author(s):  
M. Almeida ◽  
C. Gama Pereira
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Clinical State ◽  
Psychiatric Evaluation ◽  
Adequate Treatment ◽  
Global Rigidity ◽  
Eyes Closed ◽  
Pubmed Database ◽  
Wide Range ◽  
Competing Interest

IntroductionCatatonia, described by Kahlbaum in 1874, is usually seen as a type of schizophrenia, but it can also occur in a wide range of other psychiatric/organic disturbances. There is a documented association between dementia and catatonia, in all phases of cognitive impairment.AimsLiterature review and discussion about Catatonia, regarding a case report.MethodsClinical interviews and literature review in PUBMED database.Results (case report)Female patient, 89 years old, without psychiatric history, was diagnosed with dementia 5 months prior to episode. On admission, she presents with prostration, mutism and refusal to eat/drink. Laboratory studies were normal and TC-CE shows signs of an old stroke in left temporo-parietal region and diffuse signs of ischemic leucoencephalopathy. At psychiatric evaluation, she was stuporous, unreactive to pain, mute, not following verbal commands, keeping her eyes closed and resisting attempts to open her eyelids. She had global rigidity, axial and limbs, and maintains the postures the examiner puts her into for long periods. She was already given chlorpromazine, without improvement. Then she takes diazepam 10 mg iv, with remission of the state.ConclusionsAlthough catatonia usually presents with drama, clinicians often forget to consider it in differential diagnosis, probably because of its traditional association with schizophrenia. A promptly diagnostic is crucial to provide adequate treatment, avoiding drugs that can worsen/perpetuate the clinical state. Some authors even support the idea that motor features associated with end-line dementias may correspond to lorazepam-responsive catatonia, in which treatment may have a tremendous impact worldwide.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Kleptomania – “it was just a small fragrance in a Chinese store…”

2016 ◽  
Vol 33 (S1) ◽  
pp. S291-S291
Author(s):  
M. Almeida ◽  
J. Ferreira
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Social Impact ◽  
Epidemiological Data ◽  
Self Report ◽  
Clinical Samples ◽  
Pubmed Database ◽  
Co Morbidity ◽  
Shame And Guilt ◽  
Competing Interest

IntroductionThe idea that some people may not be able to control their stealing impulses emerged in 1838, when Esquirol and Marc coined the term Kleptomanie. Although there are not many studies regarding this issue, becoming therefore difficult to establish epidemiological data, various clinical samples suggest a high prevalence of the disorder. As the problem most likely become chronic when left untreated, the diagnostic approach is very important.AimsLiterature review and discussion about kleptomania, regarding a case report.MethodsClinical interviews and literature review in PUBMED database.Results (case report)Female patient, 62 years, with history of Personality Disorder and Persistent Depressive Disorder, confesses in psychiatric appointment that she had been caught stealing. She says that she has this “addiction to steal” since childhood, always stealing cheap stuff, that she does not need, usually giving it away to other people. She has this behavior as she feels an unexpected and irresistible impulse to steal, with increasing anxiety, which relieves when action is consumed. Afterwards she experiences feelings of shame and guilt. The patient symptoms appear to get worse in depressive relapses.ConclusionsRegarding individual, family and social impact of kleptomania is essential to assess it and to treat it promptly. Most of the patients are ashamed of their behavior, so they may not self-report. There are few and controversial data concerning treatment, but it is widely accepted that co-morbidity with mood disorders or substance use disorders is common and may interfere with treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Late-Onset Huntington's Disease: A Geriatric Psychiatry Perspective

1996 ◽  
Vol 9 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Kenneth I. Shulman ◽  
Anne Lennox ◽  
Harry Karlinsky
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Elderly Patients ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Psychiatric Symptoms ◽  
Late Onset ◽  
Clinical Aspects ◽  
Illustrative Case ◽  
Wide Range

Late-onset Huntington's disease is more common than has been generally appreciated and is associated with a wide range of psychiatric symptoms and syndromes. Geriatric psychiatrists have an important role to play in establishing the diagnosis and providing guidance to elderly patients and their families as they struggle with difficult management decisions. An illustrative case report and selective literature review are presented that highlight the genetic and clinical aspects of the condition.

Antidepressant withdrawal mania: Two case reports

2017 ◽  
Vol 41 (S1) ◽  
pp. S540-S540
Author(s):  
D. Pereira ◽  
I. Carreira Figueiredo ◽  
M. Marinho ◽  
R. Fernandes ◽  
V. Viveiros
Keyword(s):  
Case Report ◽  
Emergency Service ◽  
Case Reports ◽  
Unipolar Depression ◽  
Clinical State ◽  
Gradual Improvement ◽  
Clinical Criteria ◽  
The Past ◽  
Pubmed Search ◽  
Competing Interest

IntroductionAlthough rarely reported, antidepressant discontinuation may induce hypomania or mania even in the absence of bipolar disorder [1,2].ObjectivesWe report two cases of antidepressant withdrawal induced mania.MethodsClinical process consultation and PubMed search were performed in November 2016 using the search keywords antidepressant, mania and discontinuation.ResultsCase report 1: a dysthymic 60 years old woman with 20 years of psychiatric following had been treated with venlafaxine 150 mg/daily the past year. She abruptly stopped taking this drug, developing heightened mood, irritability and racing thoughts five days later. She was admitted at our hospital, initiating then valproate and antipsychotics. Two weeks later, the hypomania clinical state remitted completely.Case report 2: a 64 years old woman, with a 12-year-old diagnosis of unipolar depression was brought to our emergency service with complaints of disorganized behavior, paranoid delusional ideas, excessive speech, irritable mood and reduced need for sleep, 1 week after abrupt trazodone 150 mg/daily discontinuation. Valproic acid 1000 mg/daily and olanzapine 20 mg/daily were introduced, with gradual improvement of symptoms. Two weeks later she was completely asymptomatic.ConclusionPsychiatrists should be aware of the risk of antidepressant withdrawal induced mania. More studies should be conducted about this subject, aiming for the clarification of risk factors and the establishment of clinical criteria for this phenomenon.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Case Report of a Capgras’ Syndrome in Elderly

2016 ◽  
Vol 33 (S1) ◽  
pp. S472-S472
Author(s):  
C. Moreno Menguiano ◽  
M. Gutierrez Rodriguez ◽  
F. Garcia Sanchez ◽  
S. Bravo Herrero
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Single Case ◽  
Psychiatric Disease ◽  
Her Family ◽  
Single Case Report ◽  
Pubmed Database ◽  
Capgras Syndrome ◽  
Competing Interest ◽  
Close Relatives

IntroductionCapgras syndrome is the most frequent delusional misidentification syndrome (DMS) which was first described in 1923 by Capgras and Reboul-Lachaux as ‘L’illusion des sosies’. Consists of believe that close relatives have been replaced by nearly identical impostors. It can occur in the context of psychiatric disorders (schizophrenia, major depression) such organic, in which onset of delirium is usually later coinciding with neurological damage or neurodegenerative disease.Case reportWoman 73-year-old diagnosed of schizophrenia since more than thirty years ago. Her family talk about general impairment of the patient in the last two years. She needed a couple of psychiatric hospitalizations because of her psychiatric disease, and probably onset of cognitive impairment. In this context, we objectified the presence of a Capgras syndrome.ObjectivesTo review the literature available about Capgras syndrome in elderly and illustrate it with a clinical case.MethodsReview of literature about Capgras syndrome in elderly by searching of articles in the PubMed database of the last five years to illustrate the exposure of a single case report.ResultsThe etiology of this syndrome is not yet well understood. Advanced age is frequently found Capgras syndrome with or without the concomitant presence of an obvious cognitive impairment.ConclusionsSince it is a complex process an etiological model that combines cognitive and perceptual deficits, organic impairment and psychodynamic factors should be proposed. And it is important to make a correct differential diagnosis that allows us to carry out the best possible treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Case Report of Autointoxication with Nutmeg Committed By a Suicide attempter

2016 ◽  
Vol 33 (S1) ◽  
pp. S443-S444
Author(s):  
S. Petrykiv ◽  
L. de Jonge ◽  
P. Michielsen ◽  
M. arts
Keyword(s):  
Case Report ◽  
Suicide Attempts ◽  
Early Recognition ◽  
Hemodynamic Instability ◽  
Clinical State ◽  
Emergency Setting ◽  
Suicide Attempter ◽  
Sinus Arrhythmia ◽  
Competing Interest ◽  
Low Incidence

Introductionautointoxication with nutmeg in an emergency setting is a rare, but potentially a life-threatening event. Despite the low incidence of ‘tentamen suicidii’ (TS) with nutmeg, this substance is cheap and readily available. Early recognition of a suicide attempt with nutmeg poisoning can be extremely difficult, especially when nobody witnessed the nutmeg intake. Worldwide there are only a few cases reporting TS with nutmeg.ObjectivesTo present a case of TS with nutmeg committed by a suicide attempter.aimsTo review available literature on TS with nutmeg.Methodsa case report is presented and discussed, followed by a literature review.ResultsFive published cases of suicide attempts with nutmeg were found while searching through PUBMED and Embase. Our case describes a 57-year-old female, diagnosed with borderline personality disorder, who has been admitted to the emergency department in a state of agitation, diminished cognition, respiratory difficulties and hemodynamic instability. Electrocardiography showed a fast sinus arrhythmia with no uschemic or hypertropic changes. Blood sampling, serum and urine toxicology did not reveal any abnormalities. in view of the complexity of her condition, she admitted to have taken a large dose of nutmeg. The patient was kept for observation, offered reassurance, and rehydratation.ConclusionThe presentation of inexplicable clinical state accomplished by disturbances of central nervous, respiratory and hemodynamic systems in the population of patients with attempting suicide should alert the physician to the rare but probably underreported possibility of nutmeg autointoxication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Takayasu's arteritis in a patient with suspected acute coronary syndrome — a literature review and a case report

2021 ◽  
Vol 26 ◽  
pp. 4345
Author(s):  
D. A. Grabovyi ◽  
J. V. Dzhinibalaeva ◽  
E. V. Adonina ◽  
D. V. Duplyakov
Keyword(s):  
Acute Coronary Syndrome ◽  
Case Report ◽  
Literature Review ◽  
Takayasu’S Arteritis ◽  
Pulmonary Arteries ◽  
Diagnostic Techniques ◽  
Takayasu's Arteritis ◽  
Coronary Syndrome ◽  
American College Of Rheumatology ◽  
Wide Range

Takayasu's arteritis is a chronic granulomatous vasculitis of large vessels of unclear etiology, predominantly affecting the aorta and its main branches, with possible involvement of the coronary and pulmonary arteries. The true prevalence of this disease is unknown, but it is extremely low, given the rare diagnosis and the absence of pathognomonic symptoms. In clinical practice, the criteria proposed by the American College of Rheumatology are used for making a diagnosis. A wide range of imaging diagnostic techniques plays a significant role. This article provides a literature review and a case report of Takayasu's arteritis in a patient admitted with an acute coronary syndrome.

Schizencephaly and psychosis: A case report

2016 ◽  
Vol 33 (S1) ◽  
pp. S575-S575
Author(s):  
L. Carvalhão Gil ◽  
A. Ponte
Keyword(s):  
Case Report ◽  
Auditory Hallucinations ◽  
Brain Diseases ◽  
Pial Surface ◽  
System A ◽  
Pubmed Database ◽  
The Central Nervous System ◽  
Rare Malformation ◽  
Competing Interest ◽  
Abnormal Brain

IntroductionSchizencephaly is a rare malformation of the central nervous system, a congenital disorder of cerebral cortical development resulting in the formation of abnormal unilateral or bilateral clefts in the cerebral hemispheres that extends from the pial surface to the ventricle. It often manifests with partial seizures, mental retardation and hemiparesis.ObjectiveTo illustrate a rare case of association between psychosis and schizencephaly and the implication of this association for understanding the biology of the psychosis.MethodsA literature search was performed on PubMed database using the key words schizencephaly, psychosis, brain diseases and retrieved papers were selected according to their relevance. The patient clinical record was reviewed.ResultsThe authors report a case of a 59-year-old male admitted into a psychiatric hospital with insomnia, disorganized behavior probably secondary to auditory hallucinations and mystic delusions. He also reported epilepsy and strabismus in his right eye since his childhood and right facial paresis. A head CT scan revealed a left deep cortico-ventricular parieto-occipital communication corresponding to schizencephaly.ConclusionsConsidering the theory that schizophrenia is associated with abnormal brain development, this case report may provide an example of a neurodevelopment abnormality that manifests as psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

P108 Acetazolamide for obstructive hydrocephalus in the pregnant female: a case report and literature review.

2019 ◽  
Vol 90 (3) ◽  
pp. e50.3-e50
Author(s):  
EL Strachan ◽  
K Tsang
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Randomised Controlled Trials ◽  
Obstructive Hydrocephalus ◽  
Pregnant Patient ◽  
Database Search ◽  
Cerebrospinal Fluid Flow ◽  
Pubmed Database ◽  
Neurosurgical Patient ◽  
Randomised Controlled

ObjectivesThis study presents a case report and literature review of acetazolamide use in the pregnant patient to further delineate its role and controversies in the treatment of symptomatic hydrocephalus. Here we present a case from our neurosurgical service which demonstrated safe use and efficacy of acetazolamide in refractory hydrocephalus secondary to a space-occupying lesion.DesignCase report and literature review.Subjects33-year-old, primigravid female treated at Charing Cross Hospital, London.MethodsAdaptation of the PRISMA guideline to facilitate an initial PubMed database search for all available full-text, peer-reviewed publications in English. Papers were screened for relevance to pregnant patients with hydrocephalus receiving acetazolamide therapy, as well as relevant papers describing related disorders of cerebrospinal fluid flow.ResultsThere exist no prospective, randomised-controlled trials for the use of acetazolamide to treat hydrocephalus in pregnancy. Retrospective data in patients with related conditions suggest no significant link between acetazolamide use and teratogenicity in humans.ConclusionsAcetazolamide can be a safe and efficacious therapy in the pregnant patient with refractory hydrocephalus as a bridge to delivery. We agree with the consensus and its appropriate use in the pregnant neurosurgical patient.

Fenethylline (Captagon) abuse: Case report and literature review

2017 ◽  
Vol 41 (S1) ◽  
pp. S393-S394
Author(s):  
M. Preve ◽  
S. Casigliani ◽  
M. Godio ◽  
N.E. Suardi ◽  
R. Traber ◽  
...  
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Pain Perception ◽  
Drug Market ◽  
Future Research ◽  
Research Directions ◽  
Quantitative Studies ◽  
Future Research Directions ◽  
Competing Interest ◽  
Recreational Use

IntroductionNovel psychoactive drugs (NPS) has rapidly increase in the last years in the drug market as a recreational use. Fenethylline is a theophylline, an amphetamine-like drug, having stimulant effects similar to those of other amphetamine-type derivatives. Fenethylline was used as medicament for hyperactivity disorders in children, narcolepsy and depression, but it has also been used as a drug of abuse under the common name of ‘captagon’. The purpose of this report is to review the clinical evidence for the potential of abuse of fenethylline. We propose a case report and literature review.MethodWe conducted a systematic review of the literature with the principal database (PubMed, Enbase, PsychInfo) and we present a case report.ResultsThe effects of fenethylline is characterized by euphoria, derealization, autopsychic and somatopsychic depersonalization, hallucination, agitation and decrease of pain perception.Discussion and conclusionThe primary drug market for fenethyline (as captagon) has traditionally been countries located on the Arabian Peninsula but also North Africa since 2013. To our knowledge, there is no report on the recreational use of fenethylline in literature. The clinical features of fenethylline intoxication were also similar to effects from other amphetamine-like drugs. In our case report, dissociative symptoms are the core of fenethylline intoxication. Further research is warranted to replicate our clinical and qualitative observations and, in general, quantitative studies in large samples followed-up over time are needed. Methodological limitations, clinical implications and suggestions for future research directions are considered [1,2].Disclosure of interestThe authors have not supplied their declaration of competing interest.

Neuroleptic malignant syndrome: Case report and literature review

2017 ◽  
Vol 41 (S1) ◽  
pp. S564-S564
Author(s):  
R. Martín Gutierrez ◽  
R. Medina Blanco ◽  
P. Suarez Pinilla ◽  
R. Landera Rodriguez ◽  
M. Juncal Ruiz ◽  
...  
Keyword(s):  
Literature Review ◽  
Neuroleptic Malignant Syndrome ◽  
Life Support ◽  
Clinical Symptoms ◽  
Altered Mental Status ◽  
Antipsychotic Treatment ◽  
High Dose ◽  
Neuroleptic Treatment ◽  
Pubmed Database ◽  
Competing Interest

IntroductionNeuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal adverse effect of neuroleptic, both classic and atypical drugs.ObjectiveTo review the incidence, clinical characteristics, diagnosis and treatment of NMS.AimWe have described the case of a man of 32 years of age diagnosed with bipolar disorder treated with lithium. He precised high-dose corticosteroids after having tonsillitis. Then, he presented manic decompensation requiring neuroleptic treatment (oral risperidone). After 72 hours, he presented an episode characterized by muscular rigidity, fever, altered mental status and autonomic dysfunction. Life support measures and suspension of neuroleptic treatment were required.MethodsA literature review of the NMS was performed using the PubMed database.ResultsThe frequency of NMS ranges from 0.02 to 2.4%. The pathophysiology is not clearly understood but the blockade of dopamine receptors seems to be the central mechanism. Some of the main risk factors described are: being a young adult, the concomitant use of lithium and metabolic causes, among others. NMS occurs most often during the first week of treatment or after increasing the dosage of the neuroleptic medication. Some issues of NMS are those related with diagnosis, treatment and reintroduction of antipsychotic treatment or not.ConclusionsNMS can be difficult to diagnose due to the variability in the clinical symptoms and presentation. Because of it diagnosis is of exclusion, clinicians should always take it into consideration when a patient is treating with neuroleptic, especially when the dosage has been recently increased. NMS is a clinical emergency.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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