A mixed-ethnicity myoclonus-dystonia patient with a novel SGCE nonsense mutation: a case report

Background Myoclonus-dystonia is a rare movement disorder with an autosomal dominant inheritance pattern characterized by a combination of myoclonic jerks and dystonia that may have psychiatric manifestations. Our aim is to present neurologic and psychiatric phenotypic characteristics in the first Filipino bi-ethnic myoclonus-dystonia patient and her father. Case presentation We investigated a Filipino myoclonus-dystonia patient with a positive family history. This 21-year-old woman of mixed Filipino-Greek ethnicity presented with involuntary jerking movements of her upper extremities, head, and trunk. Her symptoms affected her activities of daily living which led her to develop moderate depression, mild to moderate anxiety, and mild obsessive-compulsive disorder (OCD). Her 49-year-old Greek father suffered from adolescence-onset myoclonus-dystonia. Conclusion Genetic testing revealed a novel epsilon-sarcoglycan (SGCE) gene nonsense mutation c.821C > A; p.Ser274* that confirmed our clinical diagnosis. For co-morbid anxiety, depression, and OCD, this patient was given duloxetine, in addition to clonazepam for the myoclonus and dystonia.

Post-malaria neurological syndrome manifesting as new onset psychosis with generalized encephalopathy: an analysis of two cases in children

Post-malaria neurological syndrome(PMNS) is a rare heterogenous syndrome heralded by the appearance of new neurological or psychiatric manifestations emerging in the post-infectious phase after clearance of malaria parasitaemia. Most cases of PMNS have been described in adults. Only seven cases have been reported in children. We describe two further cases of possible PMNS who presented with prominent psychiatric manifestations evolving into generalized encephalopathy after complete recovery from malaria. Both patients were treated with antivirals and antibiotics without clinical improvement. One patient received pulse corticosteroids and had a remarkable and rapid clinical improvement. The other recovered without specific treatment.

A Case of Wilson’s Disease Presenting with Persistant Hemolysis

Wilson’s disease is one the rare autosomal recessive disorders of copper metabolism due to mutation in ATP7B gene located in chromosome 13. The mutations of this gene cause accumulation of copper in different tissues such as brain, liver, and eyes. The clinical presentation usually reflects this tissue distribution and varies from asymptomatic patients to those with hepatic or neuro-psychiatric manifestations. Here, we report an interesting case of Wilson’s disease which presented with mild persistent hemolysis leading to pre hepatic and post hepatic jaundice. He also had hepatocellular jaundice due to liver injury.

Effects of Histobulin (Immunoglobulin/Histamine Complex) on Depression and Anxiety in Chronic Urticaria: Psychiatric Manifestations or Psychiatric Comorbidities of Chronic Urticaria?: A Case Report

Background: Psychiatric comorbidities of chronic urticaria (CU) have been reported and examined recently. The prevalence of mental disorders and emotional distress is high in patients with CU. This is a case report in which Histobulin was found to be effective for psychiatric manifestations in chronic spontaneous urticaria (CSU). Case Presentation: Three cases of CSU accompanying psychiatric manifestations (PMs) were treated with Histobulin. One patient with CSU with severe depression showed clinical changes in depressive symptoms in parallel to changes in allergic symptoms during treatment. Histobulin clearly improved not only CSU but also the accompanying PMs in one patient and slightly improved them in another patient. The PMs were not improved by an antihistamine (H1 blocker) in any case. Histobulin is effective not only for allergic manifestations (AMs) but also for PMs of CSU. Conclusions: PMs as well as AMs of CSU were improved by Histobulin therapy. PMs were suspected to be a part of the clinical manifestations in CSU, possibly through histamine-mediated mechanisms. These conditions were suggested to be ‘allergic psychiatric manifestations (APMs)’ or ‘histamine-mediated psychiatric manifestations (HPMs)’. Further study of PMs based on histamine-mediated mechanisms, including allergies, may be necessary. Accordingly, it should be clarified whether the PMs of CSU are a part of the clinical manifestations of CSU or are psychiatric comorbidities of CSU.

Hepatitis C Virus-Related Central and Peripheral Nervous System Disorders

Hepatitis C Virus (HCV), despite being a hepatotropic virus, is the causative agent of many systemic disorders, such as vasculitis, autoimmune diseases, lymphoproliferative disorders, and a broad spectrum of neurological and psychiatric manifestations. Although symptoms have been misdiagnosed or underdiagnosed, only recently, evidence of direct (inflammatory) or indirect (immune-mediated) HCV-dependent cerebral effects has been established. HCV infection can promote acute inflammatory response, pro-coagulative status and ischemic disorders, and neurodegeneration. These effects rely on cerebral HCV replication, possibly mediated by blood–brain barrier alterations. Further study is needed to better understand the HCV-related mechanisms of brain damage.

Psychiatric Complications in Patients with COVID-19: A Narrative Review

Coronavirus disease 2019 (COVID-19) is associated with severe multiorgan clinical manifestations. Although respiratory involvement is the predominant manifestation in patients infected with COVID-19, involvement of other organs, such as the nervous system, has also been identified; which highlights the virus' ability to disrupt the organs’ function. There is ample evidence of a nervous system susceptibility to the COVID-19. In this regard, the COVID-19 pandemic effect on psychological health, including insomnia, anxiety, obsessive-compulsive disorder, and depression among health care workers and other high-risk groups has been identified. So far, many studies have examined the psychiatric manifestations in infected patients with COVID-19. Undoubtedly, awareness of these findings can help in the prevention and timely treatment of these patients. This study aimed to review the possible mechanisms of COVID-19 neuroinvasive potential, psychiatric manifestations, and the management of mental disorders in infected patients.

Brain tumors and indications for brain imaging in patients with psychiatric manifestations: a case report

Background Studies on the relationship between psychiatric symptoms and brain tumors are ambiguous, as it is not clear whether these symptoms are due to the direct effect of the tumor or a secondary psychological response to stress, resulting from the diagnosis and treatment of the disease; therefore, it is difficult to analyze and retrieve relevant information. Case presentation We present the case of a 43-year-old male patient, who was admitted to a psychiatric emergency room with psychiatric symptoms, such as restlessness and extreme talkativeness, but normal neurological examinations. He showed no response to outpatient treatment and had no history of psychiatric disorders. The onset of symptoms was 2 months before his visit. On neuroimaging, a brain tumor was observed in the right temporal and occipital lobes. Accordingly, the patient was transferred to the neurosurgery ward. Conclusion Factors, such as increased internal pressure on the brain due to a brain tumor or the effect of tumor area, contribute to the occurrence of symptoms, such as restlessness and talkativeness. However, further studies are needed to confirm these findings.