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A schizophrenia-like psychotic disorder secondary to an arachnoid cyst remitted with neurosurgical treatment of the cyst.

Baquero GA, Molero P, Pla J, Ortuño F - Open Neuroimag J (2014)

Bottom Line: The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia.In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance.Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Medical Psychology, Clínica Universidad de Navarra, Pamplona, Spain.

ABSTRACT
We describe a case of delusional psychosis that was terminated by neurosurgical removal of a large arachnoid cyst. The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia. The case underscores the importance of considering that an arachnoid cyst can induce psychopathological symptoms, even those of schizophrenia. Indeed, such symptoms may be the cyst's only clinical manifestation. In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance. Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis.

No MeSH data available.


Related in: MedlinePlus

Hamilton scale scores for depression and anxiety and the PANSS general psychopathology scale score.
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Figure 2: Hamilton scale scores for depression and anxiety and the PANSS general psychopathology scale score.

Mentions: For four weeks prior to surgery the patient had received psychopharmacological treatment (escitalopram at a dose of up to 20mg/day, quetiapine at a dose of up to 300mg/day, clonazepam at a dose of up to 3mg/day, mirtazapine 15mg/day and lormetazepam 2mg/day). Despite this treatment, psychopathological symptoms (confusion, paranoid reference of events to self, delusional intepretations and fears that others intended harm, rumination on negative thoughts, sadness, emotional lability, apathy, anhedonia and social withdrawal) persisted. Improvement in this respect only occurred after surgery, when there was a 64% reduction in the Hamilton Anxiety Rating Scale Score [1], a 60% reduction in the Hamilton Depression Rating Scale Score [2] and a 55% reduction in PANSS General Psychopathology Scale Score [3] (Fig. 2).


A schizophrenia-like psychotic disorder secondary to an arachnoid cyst remitted with neurosurgical treatment of the cyst.

Baquero GA, Molero P, Pla J, Ortuño F - Open Neuroimag J (2014)

Hamilton scale scores for depression and anxiety and the PANSS general psychopathology scale score.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3959176&req=5

Figure 2: Hamilton scale scores for depression and anxiety and the PANSS general psychopathology scale score.
Mentions: For four weeks prior to surgery the patient had received psychopharmacological treatment (escitalopram at a dose of up to 20mg/day, quetiapine at a dose of up to 300mg/day, clonazepam at a dose of up to 3mg/day, mirtazapine 15mg/day and lormetazepam 2mg/day). Despite this treatment, psychopathological symptoms (confusion, paranoid reference of events to self, delusional intepretations and fears that others intended harm, rumination on negative thoughts, sadness, emotional lability, apathy, anhedonia and social withdrawal) persisted. Improvement in this respect only occurred after surgery, when there was a 64% reduction in the Hamilton Anxiety Rating Scale Score [1], a 60% reduction in the Hamilton Depression Rating Scale Score [2] and a 55% reduction in PANSS General Psychopathology Scale Score [3] (Fig. 2).

Bottom Line: The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia.In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance.Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry and Medical Psychology, Clínica Universidad de Navarra, Pamplona, Spain.

ABSTRACT
We describe a case of delusional psychosis that was terminated by neurosurgical removal of a large arachnoid cyst. The patient was suffering his first psychotic episode and had symptoms typical of schizophrenia. The case underscores the importance of considering that an arachnoid cyst can induce psychopathological symptoms, even those of schizophrenia. Indeed, such symptoms may be the cyst's only clinical manifestation. In addition, the case highlights the importance of doing a structural imaging test when confronted with a first episode of psychosis, especially if the episode is relatively late in appearance. Such imaging may lead to a diagnosis that in turn can enable a definitive neurosurgical resolution of the psychosis.

No MeSH data available.


Related in: MedlinePlus