scholarly journals Case Report: Atypical psychotic onset of type I Arnold-Chiari malformation

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 915
Author(s):  
Chiara Di Genova ◽  
Socrates Charitos ◽  
Gabriella Ba ◽  
Caterina Adele Viganò
Keyword(s):  
Chiari Malformation ◽  
Rating Scale ◽  
Psychiatric Symptoms ◽  
Brain Mri ◽  
Substantial Improvement ◽  
Psychotic Symptoms ◽  
Type I ◽  
Blurred Vision ◽  
Arnold Chiari Malformation ◽  
Axis I

Introduction: We report a case of type I Arnold-Chiari malformation that is very peculiar because of its particular onset especially characterized by psychiatric symptoms. These symptoms were so prevailing that, for fifteen years, they masked the neurological aspects and the patient was treated with high doses of psychotropic drugs without any benefit. If the Arnold-Chiari malformation had been diagnosed before the development of severe hydro-syringomyelia, the patient could have underwent decompressive neurosurgery which may have improved her quality of life. It is worthwhile to highlight that psychotic symptoms may be caused by this congenital malformation, that typically has an aspecific onset. Therefore it’s important to consider an eventual organic etiology while challenging a resistant clinical picture with unusual presentation.Case description: A 51-year-old woman reported neurological symptoms consisting of headaches, blurred vision, diplopia, tinnitus, vertigo and psychiatric symptoms including obsessive ideas about the fear of killing her son, auditory and visual pseudo-hallucinations. The symptoms had developed suddenly at the age of 35 years and persisted thereafter. She underwent multiple hospitalizations in psychiatric units and was treated with a variety of psychopharmacological approaches without substantial improvement. We performed a brain MRI that identified a type I Arnold-Chiari malformation. We assessed psychiatric symptoms using the Structured Clinical Interview for DSM IV Axis I Disorders, the Brief Psychiatric Rating Scale, and the Yale-Brown Obsessive-Compulsive Scale. A tailored psychopharmacological therapy led to a partial improvement in mood and anxiety but not in hallucinations.Discussion: We want to highlight how important is, in everyday psychiatric clinical practice, not to focus only on psychiatric aspects but consider the patient globally, because in this case psychiatric problems were the onset presentation of a rare neurological syndrome.

Arnold-Chiari Malformation Type I Associated with Syringomyelia and Atlantoaxial Instability: A Case Report

1998 ◽  
Vol 21 (4) ◽  
pp. 279
Author(s):  
Eun Jong Kim ◽  
Myung Shin Kim ◽  
Ju Young Lee ◽  
Jin Won Whang ◽  
Tae Sik Yoon
Keyword(s):  
Case Report ◽  
Chiari Malformation ◽  
Atlantoaxial Instability ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Arnold Chiari Malformation

Osteopetrosis with Arnold Chiari malformation type I and brain stem compression

2007 ◽  
Vol 74 (4) ◽  
pp. 412-415 ◽  
Author(s):  
M. L. Kulkarni ◽  
S. N. Marakkanavar ◽  
S. Sushanth ◽  
N. Pradeep ◽  
C. Ashok ◽  
...  
Keyword(s):  
Brain Stem ◽  
Chiari Malformation ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Arnold Chiari Malformation

Autoimmune limbic encephlitis. A rising differential diagnosis between diseases with psychiatric symptoms

2016 ◽  
Vol 33 (S1) ◽  
pp. S636-S636
Author(s):  
C. Martín Álvarez ◽  
F. Cadenas Extremera ◽  
V. Alonso García ◽  
M. del Valle Loarte ◽  
M. Bravo Arraez ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Limbic Encephalitis ◽  
Psychiatric Hospitalization ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Brain Mri ◽  
Caucasian Woman ◽  
Type I ◽  
Manic Symptoms ◽  
Hyperintense Signal

IntroductionIn psychiatric clinical practice, we can face numerous organic diseases in the differential diagnosis between primary psychiatric disorders. As an example of this, we can see the autoimmune limbic encephalitis(LE), which in a significant percentage of cases begins with psychiatric symptoms. Currently, one of the theories of the origin of the LE is as a idiopathic autoimmune entity, leaving behind the idea of been generated only by a viral or paraneoplastic etiology.ObjectiveTo achieve a better knowledge about this underdiagnosed entity, presenting a case of an anti-LGI1 limbic encephalitis.CaseA 60-year-old Caucasian woman who starts with neuropsychiatric symptoms as: behavioral disorders, manic symptoms, memory impairment and attention deficit.ResultsFinally, the diagnosis was confirmed when the patient had positive results in both serum and CSF samples for anti-LGI1 antibodies. Gastric neuroendocrino tumour type I was discovered. Neither paraneoplasic syndrome nor onconeuronal antibodies were shown. A thin hyperintense signal was identified in the left hippocampus using a brain MRI. Despite the patient had been treated with corticosteroids, immunosuppressants and immunoglobulins, she still showed positive antibodies in CSF samples with poor clinical results, especially psychiatric symptoms. The patient required one psychiatric hospitalization due to reference and persecutory delusions and manic symptoms.ConclusionOur patient had an unsatisfactory evolution with little response to immune treatment. Given the possible underdiagnosis of this condition, the importance of a differential diagnosis and an early treatment, we consider that there is an important need for a greater knowledge and scientific divulgation of this clinical entity.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The quality of life and psychiatric morbidity in patients operated for Arnold–Chiari malformation type I

2013 ◽  
Vol 17 (4) ◽  
pp. 259-263 ◽  
Author(s):  
Bahadir Bakim ◽  
Burcu Goksan Yavuz ◽  
Adem Yilmaz ◽  
Oguz Karamustafalioglu ◽  
Meral Akbiyik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chiari Malformation ◽  
Psychiatric Morbidity ◽  
Type I ◽  
Chiari Malformation Type I ◽  
Arnold Chiari Malformation

The impact of premenstrual dysphoric disorder among 92 bipolar patients

2010 ◽  
Vol 25 (8) ◽  
pp. 450-454 ◽  
Author(s):  
M. Fornaro ◽  
G. Perugi
Keyword(s):  
Rating Scale ◽  
Post Partum ◽  
Premenstrual Dysphoric Disorder ◽  
Clinical Variable ◽  
Type I ◽  
Co Morbidity ◽  
Axis I ◽  
Dsm Iv ◽  
Bipolar Patients ◽  
The Impact

AbstractObjectivesTo evaluate the impact of Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition (DSM-IV)-defined premenstrual dysphoric disorder (PMDD) lifetime co-morbidity among 92 bipolar patients.MethodNinety-two women with a lifetime diagnosis of DSM-IV-defined Bipolar Disorder (BD) either type I or type II were consecutively enrolled to determine co-morbidity rates with PMDD and associated clinical features. Measures included the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) and the Clinical Global Impression (CGI) rating scale.ResultsIn our sample, 25 (27.2%) patients reported a lifetime history of PMDD according to DSM-IV criteria (PMDD+). PMDD+ reported higher rates of Cyclothymia and BP-II than PMDD− (respectively 72% vs. 36% and 88% vs. 60%). On the contrary, the carbohydrate-craving feature was more represented among PMDD− than PMDD+ (25% vs. 4%). PMDD was also significantly associated with post-partum depression (36% vs. 15%), Obsessive-Compulsive (24% vs. 7.5%) and Body Dysmorphic Disorders (24% vs. 6%). Finally, PMDD+ reported higher total number of Axis I co-morbid disorders than PMDD−.ConclusionsIn our cohort of BD women, PMDD is a frequent co-morbid condition, in particular among patients with BD-II or Cyclothymia. Multiple co-morbidities also represent a clinical variable associated with PMDD. Further perspective studies are necessary to better define the relationships between PMDD and BD.

Short, severe dizziness attacks in a pregnant woman with type I ARNOLD–Chiari malformation

2015 ◽  
Vol 36 (4) ◽  
pp. 430-431
Author(s):  
M. Ono ◽  
A. Kojima ◽  
M. Shirahashi ◽  
S. Noda ◽  
Y. Akiba ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Chiari Malformation ◽  
Type I ◽  
Arnold Chiari Malformation

scholarly journals Type I Arnold-Chiari malformation with bronchiectasis, respiratory failure, and sleep disordered breathing: a case report

2013 ◽  
Vol 8 ◽  
Author(s):  
Raffaele Campisi ◽  
Nicola Ciancio ◽  
Laura Bivona ◽  
Annalisa Di Maria ◽  
Giuseppe Di Maria
Keyword(s):  
Respiratory Failure ◽  
Chiari Malformation ◽  
Sleep Disordered Breathing ◽  
Clinical Manifestations ◽  
Low Flow ◽  
Cervical Canal ◽  
Type I ◽  
Arnold Chiari Malformation ◽  
Pulmonary Manifestations ◽  
Disordered Breathing

Arnold Chiari Malformation (ACM) is defined as a condition where part of the cerebellar tissue herniates into the cervical canal toward the medulla and spinal cord resulting in a number of clinical manifestations. Type I ACM consists of variable displacement of the medulla throughout the formamen magnum into the cervical canal, with prominent cerebellar herniation. Type I ACM is characterized by symptoms related to the compression of craniovertebral junction, including ataxia, dysphagia, nistagmus, headache, dizziness, and sleep disordered breathing. We report a case of a life-long nonsmoker, 54 years old woman who presented these symptoms associated with bronchiectasis secondary to recurrent inhalation pneumonia, hypercapnic respiratory failure, and central sleep apnea (CSA). CSA was first unsuccessfully treated with nocturnal c-PAP. The subsequent treatment with low flow oxygen led to breathing pattern stabilization with resolution of CSA and related clinical symptoms during sleep. We suggest that in patients with type I ACM the presence of pulmonary manifestations aggravating other respiratory disturbances including sleep disordered breathing (SDB) should be actively investigated. The early diagnosis is desirable in order to avoid serious and/or poorly reversible damages.

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