scholarly journals Catatonia associated with late-life psychosis successfully treated with lithium: a case report

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hiroko Sugawara ◽  
Junpei Takamatsu ◽  
Mamoru Hashimoto ◽  
Manabu Ikeda
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Treatment Strategies ◽  
Late Life ◽  
Psychotic Symptoms ◽  
Case Presentation ◽  
Limited Efficacy ◽  
Cumulative Evidence ◽  
The Brain

Abstract Background Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late-life psychosis, which was successfully treated with lithium. Case presentation A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy. Conclusions Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.

scholarly journals Catatonia Associated With Late Paraphrenia Successfully Treated With Lithium: A Case Report

2020 ◽  
Author(s):  
Hiroko Sugawara ◽  
Junpei Takamatsu ◽  
Mamoru Hashimoto ◽  
Manabu Ikeda
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Late Onset ◽  
Treatment Strategies ◽  
Psychotic Symptoms ◽  
Case Presentation ◽  
Limited Efficacy ◽  
Cumulative Evidence ◽  
The Brain

Abstract Background: Catatonia is a psychomotor syndrome that presents various symptoms ranging from stupor to agitation, with prominent disturbances of volition. Its pathogenesis is poorly understood. Benzodiazepines and electroconvulsive therapy (ECT) are safe and effective standard treatments for catatonia; however, alternative treatment strategies have not been established in cases where these treatments are either ineffective or unavailable. Here, we report a case of catatonia associated with late paraphrenia classified as very-late-onset schizophrenia-like psychosis, which was successfully treated with lithium. Case presentation: A 66-year-old single man with hearing impairment developed hallucination and delusions and presented with catatonic stupor after a fall. He initially responded to benzodiazepine therapy; however, his psychotic symptoms became clinically evident and benzodiazepine provided limited efficacy. Blonanserin was ineffective, and ECT was unavailable. His catatonic and psychotic symptoms were finally relieved by lithium monotherapy.Conclusions: Catatonic symptoms are common in patients with mood disorders, suggesting that lithium may be effective in these cases. Moreover, lithium may be effective for both catatonic and psychotic symptoms, as it normalizes imbalances of excitatory and inhibitory systems in the brain, which underlies major psychosis. Cumulative evidence from further cases is needed to validate our findings.

Survival of multiple nail gun injuries to the head, lung, and heart: A case report

2020 ◽  
Author(s):  
Suo-Hsien Wang ◽  
Mao-Yu Chen ◽  
Tzu-Yen Huang ◽  
Che-Chia Chang ◽  
Chih-Ying Chien
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Suicide Attempt ◽  
Surgical Planning ◽  
Surgical Intervention ◽  
Treatment Strategies ◽  
Emergency Physicians ◽  
Significant Morbidity ◽  
Case Presentation ◽  
The Brain

Abstract Background: Most nail gun injuries occur at the extremities due to working accidents. Injuries to the brain or thorax are relatively rare, and cases with both injuries are even rarer. Initial evaluation, resuscitation and surgical planning can be challenging. Case presentation: Here, we present a case with nail gun injuries to the brain, lung, and heart by suicide attempt. The patient presented to the emergency department under shock. After resuscitation and surgical intervention, he was discharged without significant morbidity. Conclusions: Multiple nail gun injuries, especially those to vital organs such as the brain, lung, and heart, can be challenging to emergency physicians and surgeons. Imaging tools, treatment strategies, and possible complications are discussed in this article to provide optimized outcomes in such situations.

scholarly journals Thermal burns in electroconvulsive therapy

2021 ◽  
pp. 201010582110310
Author(s):  
Ernest Weisheng Ho ◽  
Eng Leonard ◽  
Lee Tih-Shih ◽  
Gregory James Meredith
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Ignition Source ◽  
Thermal Burns ◽  
High Impedance ◽  
Temporal Placement ◽  
Close Proximity ◽  
Life Threatening

Electroconvulsive therapy (ECT) is effective for mood disorders and schizophrenia. Thermal burns, while rare, are potentially sight and life threatening. The three elements necessary for a fire are often in close proximity during a session: an oxidiser (oxygen), an ignition source (faulty electrodes, poor contact with skin producing a spark) and fuel (hair, residual alcohol cleanser). This case report describes one such incident when a patient sustained a burn during ECT, with poor contact of electrode pad with skin, high impedance and an oxygen-rich environment possibly contributing. Given that ECT is conducted relatively frequently (once every 2–3 days) in a usual regimen, we make recommendations for safe application of electrode pads for temporal placement ECT.

scholarly journals Persistent delusional theme over 13 episodes of psychotic depression

2013 ◽  
Vol 25 (6) ◽  
pp. 370-373 ◽  
Author(s):  
Søren Dinesen Østergaard ◽  
Anne Katrine K. Leadholm ◽  
Anthony J. Rothschild
Keyword(s):  
Case Report ◽  
Electroconvulsive Therapy ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Psychotic Depression ◽  
Medical File ◽  
Course Of Illness ◽  
Clinical Phenomenon ◽  
Initial Episode ◽  
Multiple Episodes

ObjectiveUnipolar psychotic depression (PD) is a highly debilitating condition, which needs intense monitoring and treatment. Among patients with recurrent PD, delusions tend to be very similar or identical over several separate episodes during the course of illness, but case reports illustrating this clinical phenomenon in detail are lacking from the literature.MethodsCase report describing the 45-year-old Ms. J, who has experienced multiple episodes of PD. The report is based on a review of her medical file.ResultsThe delusional theme of Ms. J's initial episode of PD reappeared at several subsequent episodes. During the majority of admissions, Ms. J was treated with electroconvulsive therapy, which resulted in significant improvement in the depressive, psychotic and catatonic features.ConclusionMs. J's case illustrates that PD can be a stable phenotype over many episodes and that it is important to recognise psychotic symptoms in order to prescribe the best possible treatment.

scholarly journals Co-occuring Toxoplasma Infection and Psychotic Symptoms : Case Report

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Carla R Marchira ◽  
Andrian F Kusumadewi ◽  
Patricia Wulandari
Keyword(s):  
Life Support ◽  
The United States ◽  
The Body ◽  
Psychotic Symptoms ◽  
Toxoplasma Infection ◽  
Case Presentation ◽  
The Family ◽  
Brain Neurotransmitter ◽  
The Brain

Abstract   Introduction Schizophrenia is a neuropsychiatric disease that is global and is experienced by 1% of the population in the United States and Europe. This study raises awareness of the role of infectious agents in the initiation of psychotic symptoms in schizophrenia. Case Presentation A 20-year-old man is taken by the family to the emergency department because he has decreased consciousness, and the body suddenly stiffens. Patients begin to experience changes in behavior in the form of difficulty sleeping, when invited to talk quietly, laughing alone and whispering without the other person. TORCH examination found an increase in anti-toxoplasma IgM and IgG. This patient is then given basic life support in the form of ABC (airway, breathing, circulation support) and seizure management. Also given risperidone 2 mg / 12 hours, pyrimethamine 1-II (1x200 mg), pyrimethamine day III-XXI (1x 25 mg), intravenous Cefotaxim 2g / 8 hours, Clindamycin 500 mg / 8 hours. The patient experienced improvement after the second week of treatment. Conclusion Toxoplasmosis causes lesions in the brain that cause changes in brain neurotransmitter pathways, which lead to changes in patient behavior.

scholarly journals Case Report: Organic Hallucinosis in Viral Encephalitis

2021 ◽  
Vol 2 (1) ◽  
pp. 61-64
Author(s):  
Andrian Fajar Kusumadewi
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Mental Disorders ◽  
Viral Encephalitis ◽  
Case Presentation ◽  
The Family ◽  
Organic Mental Disorders ◽  
History Of ◽  
The Brain

Introduction : Organic mental disorders are diseases we need to put more attentionon because they are related to systemic disorders or disorders of the brain and cancause high mortality. Organic mental disorders often manifest in the form ofpsychiatric symptoms so that they can be treated too late because the physician isnot able to recognize the symptoms which can be fatal. Sequelae can be found inorganic mental disorders and may affect the patient’s quality of life, so a fast andproper management is needed to get a better outcome. Case presentation: A caseof organic hallucinosis in viral encephalitis had been reported in a 18 year-old malewith a history of sudden changes in behaviour. The symptoms appeared after thepatient had problems during OSPEK and was threatened by someone. The patientwas the only child in the family and often spoiled by his parents. Laboratory andimaging studies showed that there was a cerebritis in the CT scan result, a decreasein CD4 count, and an increase in anti-Rubella IgG titers in which the patient wasfinally diagnosed with viral encephalitis. Conclusion: The diagnosis of organicmental disorders can easily be overlooked in daily clinical practice so that patientsdo not receive proper management

Status epilepticus, electroconvulsive therapy and malignant melanoma

2009 ◽  
Vol 26 (2) ◽  
pp. 87-89
Author(s):  
Kenneth R Kaufman ◽  
Aviva Olsavsky
Keyword(s):  
Adverse Effect ◽  
Central Nervous System ◽  
Nervous System ◽  
Case Report ◽  
Status Epilepticus ◽  
Malignant Melanoma ◽  
Electroconvulsive Therapy ◽  
Pertinent Literature ◽  
Cns Pathology ◽  
The Brain

AbstractStatus epilepticus (SE), both convulsive and nonconvulsive, is a rare adverse effect of electroconvulsive therapy (ECT). This case report describes SE post-ECT associated with central nervous system (CNS) metastatic melanoma and reviews pertinent literature. The authors recommend that when CNS pathology is suspected, pre-ECT neurology consultation, neuroimaging, and EEG all may be indicated. This is especially important for patients with histories of primary cancers, such as melanoma, that metastasise to the brain.

scholarly journals Extracorporeal Membrane Oxygenation for Secondary Organizing Pneumonia after Severe SARS-CoV-2 Infection: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1013
Author(s):  
Tomoyuki Kimura ◽  
Chisato Onitsuka ◽  
Tomoko Kawahara ◽  
Yosuke Fukuda ◽  
Tetsuya Homma ◽  
...  
Keyword(s):  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Large Scale ◽  
Late Phase ◽  
Treatment Strategies ◽  
Favorable Outcome ◽  
Organizing Pneumonia ◽  
Case Presentation ◽  
Membrane Oxygenation ◽  
Life Threatening

(Background) COVID-19 is caused by SARS-CoV-2 infection and may result in unfavorable outcomes. A recent large-scale study showed that treatment with dexamethasone leads to favorable outcomes in patients with severe COVID-19, and the use of extracorporeal membrane oxygenation (ECMO) has also been shown to improve outcomes. Recently, secondary organizing pneumonia (SOP) has been reported after SARS-CoV-2 infection, but the diagnostic and treatment strategies are still unclear. (Case presentation) Here, we report a patient with severe COVID-19 who developed SOP even after the use of dexamethasone, for whom the introduction of ECMO on the 19th day after hospitalization led to a favorable outcome. (Conclusions) Life-threatening SOP may evolve even after the use of dexamethasone, and the late-phase introduction of ECMO may save such patients with COVID-19.

scholarly journals Brucella-Induced Acute Psychosis: A Novel Cause of Acute Psychosis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Chi-Chi Obuaya ◽  
Gayathri Thivyaa Gangatharan ◽  
Efthimia Karra
Keyword(s):  
Case Report ◽  
East Asia ◽  
General Hospital ◽  
Psychotic Symptoms ◽  
South East Asia ◽  
Acute Psychosis ◽  
Organic Psychosis ◽  
Quadrant Pain ◽  
Serological Tests ◽  
Case Presentation

Background. Infections have long been linked to psychosis and categorised within “secondary” psychoses. To date, there have been few reports of psychosis linked to brucellosis. This case report aims to present one such case. Case Presentation. A 31-year-old man was admitted to a general hospital with pyrexia, severe right upper quadrant pain, and an acute psychosis following a two-week holiday in South East Asia and the Mediterranean. Serological tests revealed that he had brucellosis. Following antibiotic treatment, the psychotic symptoms abated and he was discharged within ten days of hospitalisation. Conclusions. This case of organic psychosis highlights the importance of considering brucellosis as a rare cause of acute psychosis. The exact mechanism of Brucella-induced psychosis remains unclear.

Assessing Diagnosis and Symptoms Profiles of Late-Life Psychosis

GeroPsych ◽  
2013 ◽  
Vol 26 (4) ◽  
pp. 205-209 ◽  
Author(s):  
Ali Javadpour ◽  
Maryam Sehatpour ◽  
Arash Mani ◽  
Ali Sahraian
Keyword(s):  
Differential Diagnosis ◽  
Mood Disorders ◽  
Psychotic Disorders ◽  
Late Onset ◽  
Late Life ◽  
Psychotic Symptoms ◽  
Elderly Persons ◽  
Visual Hallucinations ◽  
Symptom Profiles ◽  
Symptom Profile

Background: There are many controversies with regard to the nosology and conditions causing psychosis in old age people. This study defines a symptom profile and differential diagnosis of late-onset psychosis. Method: 201 elderly persons with psychotic symptoms were recruited. All patients were interviewed based on SCID-1 to confirm the possible diagnosis. Results: The most delusional symptom reported by the subjects was persecutory delusion, and visual hallucinations were the most common hallucination. The most repeated diagnosis was dementia, followed by psychosis due to mood disorders, primary psychotic disorders, delirium, and psychosis due to medical conditions. Conclusions: Results from the current study indicate that late-life psychoses form a heterogeneous group of disorders with varying symptom profiles and etiologies.

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