Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2022.100352
A. Miguélez Rodríguez
Anti-Ma-2 encephalitis is a rare autoimmune condition which can display a wide range of neuropsychiatric symptoms. It is usually paraneoplastic as 96% of the cases are linked to the presence of a tumor, mainly testicular or pulmonary. Many of these patients can usually be misdiagnosed psychiatrically months before the proper diagnosis is set. Diagnostic battery tests must be exhaustive and treatment includes several lines of medications and treatment of the primary tumor, which determines severe but better prognosis than the rest of autoimmune encephalitic processes. Herein, we present a paradigmatic and almost unique clinical case of a 51-year-old man who was affected of this condition, suffering from left hemichorea, cerebellar and limbic symptoms. The symptomatology had been refractory to several treatment lines and no hidden tumor was detected. The case is accompanied by a narrative concise review of this condition. The wide range of symptomatology displayed, often preceding tumor diagnosis and its severe prognosis make essential to suspect these autoimmune entities when facing neuropsychiatric unusual and complex clinical pictures. Only two previous cases of Anti-Ma 2 encephalitis have been described before with these clinical manifestations, one in Iran and the other one in Germany.
{"title":"Anti-MA2 autoinmune encephalitis: A unique case report and narrative concise review","authors":"A. Miguélez Rodríguez","doi":"10.1016/j.psiq.2022.100352","DOIUrl":"10.1016/j.psiq.2022.100352","url":null,"abstract":"<div><p><span>Anti-Ma-2 encephalitis is a rare autoimmune condition which can display a wide range of neuropsychiatric symptoms. It is usually paraneoplastic as 96% of the cases are linked to the presence of a tumor, mainly testicular or pulmonary. Many of these patients can usually be misdiagnosed psychiatrically months before the proper diagnosis is set. Diagnostic battery tests must be exhaustive and treatment includes several lines of medications and treatment of the primary tumor, which determines severe but better prognosis than the rest of autoimmune encephalitic processes. Herein, we present a paradigmatic and almost unique clinical case of a 51-year-old man who was affected of this condition, suffering from left hemichorea, cerebellar and limbic symptoms. The </span>symptomatology had been refractory to several treatment lines and no hidden tumor was detected. The case is accompanied by a narrative concise review of this condition. The wide range of symptomatology displayed, often preceding tumor diagnosis and its severe prognosis make essential to suspect these autoimmune entities when facing neuropsychiatric unusual and complex clinical pictures. Only two previous cases of Anti-Ma 2 encephalitis have been described before with these clinical manifestations, one in Iran and the other one in Germany.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114854427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2022.100353
Luz María González Gualda , Rocío Sáez Povedano , Paloma Cano-Ruiz , Miguel Barberán Navalón
Objective
To present a case report on the use of tiapride for alcohol detoxification in a patient diagnosed with alcohol use disorder.
Clinical case
A 50-year-old woman, under follow-up in the Addictive Behaviour Unit from September 2016 to date, with a diagnosis of adjustment disorder with mixed emotional disturbance, alcohol use disorder and mood decompensation, for which treatment with tiapride was initiated.
Results
The studies consulted demonstrate the efficacy and safety of tiapride for alcohol withdrawal syndrome, in both outpatient and inpatient settings, in monotherapy or in polytherapy with benzodiazepines and/or antiepileptics, and used for agitation and/or psychotic symptoms.
Conclusions
Tiapride has been found to be effective in alcohol withdrawal syndrome and could even be considered adjunctive treatment to benzodiazepines or anticonvulsants. Looking to the future, pharmacogenetics affecting alcohol use disorder should be considered, and this could result in tailored, personalised therapy, with fewer adverse effects.
{"title":"Tiapride, una alternativa de tratamiento para el trastorno por el uso de alcohol: a propósito de un caso","authors":"Luz María González Gualda , Rocío Sáez Povedano , Paloma Cano-Ruiz , Miguel Barberán Navalón","doi":"10.1016/j.psiq.2022.100353","DOIUrl":"10.1016/j.psiq.2022.100353","url":null,"abstract":"<div><h3>Objective</h3><p>To present a case report on the use of tiapride for alcohol detoxification in a patient diagnosed with alcohol use disorder.</p></div><div><h3>Clinical case</h3><p>A 50-year-old woman, under follow-up in the Addictive Behaviour Unit from September 2016 to date, with a diagnosis of adjustment disorder with mixed emotional disturbance, alcohol use disorder and mood decompensation, for which treatment with tiapride was initiated.</p></div><div><h3>Results</h3><p>The studies consulted demonstrate the efficacy and safety of tiapride for alcohol withdrawal syndrome, in both outpatient and inpatient settings, in monotherapy or in polytherapy with benzodiazepines and/or antiepileptics, and used for agitation and/or psychotic symptoms.</p></div><div><h3>Conclusions</h3><p>Tiapride has been found to be effective in alcohol withdrawal syndrome and could even be considered adjunctive treatment to benzodiazepines or anticonvulsants. Looking to the future, pharmacogenetics affecting alcohol use disorder should be considered, and this could result in tailored, personalised therapy, with fewer adverse effects.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125836935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2021.100348
Jesús E. Ibáñez-Vizoso, Agustín Bermejo-Pastor, Belén Rodado-León
Paratonia is motor tone disturbance, of interest in neuropsychiatry due to its involvement in the semiology of dementia and catatonia. In paratonia, resistance to passive manipulation is erratic and depends on the intensity of the imposed movement. It is usually divided into an oppositional subtype (gegenhalten) and a facilitatory subtype (mitgehen). Efforts have been made in the field of dementia to establish a consensus definition of paratonia and to describe different exploratory manoeuvres. This contrasts with the conceptual ambiguity and heterogeneity found in the psychiatric literature regarding this term, which still appears in multiple scales and diagnostic criteria for catatonia. This is a problem given the general difficulties in defining and operationalising the characteristic signs of catatonia and in the creation of universally accepted assessment instruments. This article provides a review of scientific literature on paratonia to describe this problem, and encourage advances made in its research by other fields that could serve as a reference for its study in psychiatry.
{"title":"Paratonía: un signo relevante en neuropsiquiatría","authors":"Jesús E. Ibáñez-Vizoso, Agustín Bermejo-Pastor, Belén Rodado-León","doi":"10.1016/j.psiq.2021.100348","DOIUrl":"10.1016/j.psiq.2021.100348","url":null,"abstract":"<div><p>Paratonia is motor tone disturbance, of interest in neuropsychiatry due to its involvement in the semiology of dementia and catatonia. In paratonia, resistance to passive manipulation is erratic and depends on the intensity of the imposed movement. It is usually divided into an oppositional subtype (gegenhalten) and a facilitatory subtype (mitgehen). Efforts have been made in the field of dementia to establish a consensus definition of paratonia and to describe different exploratory manoeuvres. This contrasts with the conceptual ambiguity and heterogeneity found in the psychiatric literature regarding this term, which still appears in multiple scales and diagnostic criteria for catatonia. This is a problem given the general difficulties in defining and operationalising the characteristic signs of catatonia and in the creation of universally accepted assessment instruments. This article provides a review of scientific literature on paratonia to describe this problem, and encourage advances made in its research by other fields that could serve as a reference for its study in psychiatry.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115154703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2022.100354
Lisandro Vales
Introduction
Traumatic Brain Injury (TBI) is the most common cause of neurological disability in young patients. Empathy, an important factor of social cognition, allows a satisfactory interaction of the subject with his environment. Their deficits will suggest inadequate social perceptions, inappropriate answers, and social isolation. The ability to understand, be sensitive and represent the mental states of others, apparently would be related to the ability to represent our mental states, being fundamental to self-awareness.
Materials and methods
A descriptive and quantitative study was performed. Objective: to observe the relationship between self-awareness and empathy in moderate or severe TBI patients.
Patients: 31 Outpatients, aged between 16 and 45 years with a diagnosis of moderate or severe TBI, who attended the Neuropsychology Department of the Clinics Hospital (Montevideo – Uruguay).
Instruments: Patient Competency Rating Scale (PCRS) (self-awareness = PCRS of the patient - PCRS family), Interpersonal Reactivity Index (IRI) that assesses empathy, and the Lesion Pattern (PL) by accessing the Computational Axial Tomography (CT) report.
Results
Significant differences between the patient report and the family report after the TBI in the IRI Fantasy dimension (p = 0.0485), as well as in the IRI Perspective Taking dimension (p = 0.0090). 52% of patients present an impairment of self-awareness. Association between activities of daily living of self-awareness and fantasy of empathy (r = − 0.63, p = 0.009). Significant behavior between personal distress of empathy (IRI) with high and low levels of self-awareness according to the median (p = 0.0207) (low levels of self-awareness are associated with less value in personal distress), and between self-awareness with patients with or without neurosurgery (p = 0,0295) (patients with surgery have less self-awareness).
Frontal (p = 0.0358, n = 24) and frontotemporal lesions (p = 0.0478, n = 24) have lower value in the fantasy dimension of empathy (IRI). Bilateral frontal (p = 0.0460, n = 24) lesions and rights (p = 0.0175), n = 24) have lower value in emotional self-awareness.
Conclusions
Patients who have suffered a moderate or severe TBI have a decrease in empathy and self-awareness. Neurosurgery, one of the most frequent interventions in the treatment of severe TBIs, can result in impaired self-awareness (ISA).
Patients with ISA have difficulties in managing their personal distress of the IRI (emotional dimension of empathy), losing the ability to perform a real examination of their emotional and behavioral states. We can also say that the difficulties in handling personal distress could be an obstacle to improving your self-awareness.
Fantasy (IRI), the cognitive dimension of empathy, is related to the self-awarenes
{"title":"Empatía y autoconciencia en los pacientes con traumatismo cráneo-encefálico moderado y severo","authors":"Lisandro Vales","doi":"10.1016/j.psiq.2022.100354","DOIUrl":"10.1016/j.psiq.2022.100354","url":null,"abstract":"<div><h3>Introduction</h3><p>Traumatic Brain Injury (TBI) is the most common cause of neurological disability in young patients. Empathy, an important factor of social cognition, allows a satisfactory interaction of the subject with his environment. Their deficits will suggest inadequate social perceptions, inappropriate answers, and social isolation. The ability to understand, be sensitive and represent the mental states of others, apparently would be related to the ability to represent our mental states, being fundamental to self-awareness.</p></div><div><h3>Materials and methods</h3><p>A descriptive and quantitative study was performed. Objective: to observe the relationship between self-awareness and empathy in moderate or severe TBI patients.</p><p>Patients: 31 Outpatients, aged between 16 and 45 years with a diagnosis of moderate or severe TBI, who attended the Neuropsychology Department of the Clinics Hospital (Montevideo – Uruguay).</p><p>Instruments: Patient Competency Rating Scale (PCRS) (self-awareness = PCRS of the patient - PCRS family), Interpersonal Reactivity Index (IRI) that assesses empathy, and the Lesion Pattern (PL) by accessing the Computational Axial Tomography (CT) report.</p></div><div><h3>Results</h3><p>Significant differences between the patient report and the family report after the TBI in the IRI Fantasy dimension (<em>p</em> = 0.0485), as well as in the IRI Perspective Taking dimension (<em>p</em> = 0.0090). 52% of patients present an impairment of self-awareness. Association between activities of daily living of self-awareness and fantasy of empathy (<em>r</em> = −<!--> <!-->0.63, <em>p</em> = 0.009). Significant behavior between personal distress of empathy (IRI) with high and low levels of self-awareness according to the median (<em>p</em> = 0.0207) (low levels of self-awareness are associated with less value in personal distress), and between self-awareness with patients with or without neurosurgery (<em>p</em> = 0,0295) (patients with surgery have less self-awareness).</p><p>Frontal (p = 0.0358, n = 24) and frontotemporal lesions (p = 0.0478, n = 24) have lower value in the fantasy dimension of empathy (IRI). Bilateral frontal (p = 0.0460, n = 24) lesions and rights (p = 0.0175), n = 24) have lower value in emotional self-awareness.</p></div><div><h3>Conclusions</h3><p>Patients who have suffered a moderate or severe TBI have a decrease in empathy and self-awareness. Neurosurgery, one of the most frequent interventions in the treatment of severe TBIs, can result in impaired self-awareness (ISA).</p><p>Patients with ISA have difficulties in managing their personal distress of the IRI (emotional dimension of empathy), losing the ability to perform a real examination of their emotional and behavioral states. We can also say that the difficulties in handling personal distress could be an obstacle to improving your self-awareness.</p><p>Fantasy (IRI), the cognitive dimension of empathy, is related to the self-awarenes","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133674889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diogenes syndrome is a challenge for clinicians. It is described in older adults. It is characterized by extreme neglect of self-care, accumulation of useless objects, self-neglect, social isolation and no awareness of illness. Between a third and a half of the patients have frontotemporal dementias or a mental disorder. We present the case of a 71-year-old male admitted to psychiatry due to behavioral disorders. He presents hoarding behavior, neglect of hygiene, disorganization and loss of habits. The behavior generates neighborhood conflicts and social alarm, for which social services intervene. Neuroimaging studies do not provide significant pathologic findings. Neuropsychological examination showed mild involvement of dorsolateral, dorsomedial, and orbitofrontal prefrontal areas. No acute psychopathology was observed. Multidisciplinary intervention is performed in a day hospital, with behavioral supervision, time structuring plan, promotion of autonomy and social support. This case shows the complexity of the diagnostic process and the mobilization of social, health and legal resources given the repercussions in all areas.
{"title":"La complejidad neuroconductual del síndrome de diógenes: a propósito de un caso","authors":"Nora Yárnoz-Goñi , Raquel Ruiz Ruiz , Adriana Goñi-Sarriés","doi":"10.1016/j.psiq.2022.100351","DOIUrl":"10.1016/j.psiq.2022.100351","url":null,"abstract":"<div><p>Diogenes syndrome is a challenge for clinicians. It is described in older adults. It is characterized by extreme neglect of self-care, accumulation of useless objects, self-neglect, social isolation and no awareness of illness. Between a third and a half of the patients have frontotemporal dementias or a mental disorder. We present the case of a 71-year-old male admitted to psychiatry due to behavioral disorders. He presents hoarding behavior, neglect of hygiene, disorganization and loss of habits. The behavior generates neighborhood conflicts and social alarm, for which social services intervene. Neuroimaging studies do not provide significant pathologic findings. Neuropsychological examination showed mild involvement of dorsolateral, dorsomedial, and orbitofrontal prefrontal areas. No acute psychopathology was observed. Multidisciplinary intervention is performed in a day hospital, with behavioral supervision, time structuring plan, promotion of autonomy and social support. This case shows the complexity of the diagnostic process and the mobilization of social, health and legal resources given the repercussions in all areas.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114206779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2021.100350
Judith Alvarez Borillo, Paula Mollà Roig, Nora Yarnoz Goñi, Ana Goñi Navarro, Óscar Bueno Sainz
Bipolar Disorder (BP) is one of the psychiatric disorders with a higher heritability rate, not only of bipolar disorder, but other forms of affective and mood disorders as well, including cyclothymic disorder (CD). Given this information, early detection in young descendants seems of the utmost importance. We present de clinical case of a 16 years old female, with a first-degree relative affected by BD Type I, referred to our unit given the presence of affective symptoms, for its study and treatment.
{"title":"Trastorno ciclotímico de inicio en la adolescencia: a propósito de un caso clínico","authors":"Judith Alvarez Borillo, Paula Mollà Roig, Nora Yarnoz Goñi, Ana Goñi Navarro, Óscar Bueno Sainz","doi":"10.1016/j.psiq.2021.100350","DOIUrl":"10.1016/j.psiq.2021.100350","url":null,"abstract":"<div><p>Bipolar Disorder (BP) is one of the psychiatric disorders with a higher heritability rate, not only of bipolar disorder, but other forms of affective and mood disorders as well, including cyclothymic disorder (CD). Given this information, early detection in young descendants seems of the utmost importance. We present de clinical case of a 16 years old female, with a first-degree relative affected by BD Type I, referred to our unit given the presence of affective symptoms, for its study and treatment.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131145531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cycloid psychosis is a nosological entity characterized by an acute onset, a remitting course, a favorable outcome and a symptomatological polymorphism. Its origin dates back to 1928 and its consideration as an independent diagnosis is currently controversial, since there is a lack of solid scientific evidence to support it. However, this article defends its validity as a specific nosology, with implications regarding treatment and, consequently, prognosis. For this purpose, we present the clinical case of a 37-year-old woman, admitted for the first time to the psychiatric inpatient unit due to a psychotic episode, which will resolve within days and will repeat recurrently, remaining asymptomatic and without cognitive impairment between different episodes.
{"title":"Psicosis cicloide como diagnóstico válido y específico. A propósito de un caso","authors":"Begoña Itziar Pérez Longás, Belén Urban Anton, Francesc Pascual Sanchis","doi":"10.1016/j.psiq.2021.100349","DOIUrl":"10.1016/j.psiq.2021.100349","url":null,"abstract":"<div><p>Cycloid psychosis is a nosological entity characterized by an acute onset, a remitting course, a favorable outcome and a symptomatological polymorphism. Its origin dates back to 1928 and its consideration as an independent diagnosis is currently controversial, since there is a lack of solid scientific evidence to support it. However, this article defends its validity as a specific nosology, with implications regarding treatment and, consequently, prognosis. For this purpose, we present the clinical case of a 37-year-old woman, admitted for the first time to the psychiatric inpatient unit due to a psychotic episode, which will resolve within days and will repeat recurrently, remaining asymptomatic and without cognitive impairment between different episodes<strong>.</strong></p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122895561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2021.100338
Nora Yárnoz-Goñi , Adriana Goñi-Sarriés , Jose Torres-Valdés
Objective
To present the clinical case of a severe phase of mania suffering from a possible Neuroleptic Malignant Syndrome (NMS).
Clinical case
16-year-old girl, native of Spain, family of Algerian background. Diagnosed with bipolar disorder. In the current episode, she begins a psychopathological decompensation after abandoning psychopharmacological treatment. She presents agripnia, irritability, escapes from home, expansive mood, as well as behavioral alterations rejecting any practice of her Islamic culture. Due to all this, she needs an involuntary admission to the hospitalization unit. During this, due to serious behaviors, mechanical and pharmacological restraint is required. Suddenly she begins to develop fever, generalized tremor and increased CPK in blood tests, which led to her transfer to the ICU for observation and intensive treatment due to the possibility of NMS.
Results
After stabilization, discharged was decided with a diagnosis of possible NMS and respiratory infection, with evident clinical improvement.
Conclusions
There are no universal criteria for NMS, the patient presents several typical symptoms but it is not possible to confirm that we are before a NMS in its totality. Socio-cultural aspects modulate psychopathology in a characteristic way.
{"title":"Manía transcultural en UCI","authors":"Nora Yárnoz-Goñi , Adriana Goñi-Sarriés , Jose Torres-Valdés","doi":"10.1016/j.psiq.2021.100338","DOIUrl":"10.1016/j.psiq.2021.100338","url":null,"abstract":"<div><h3>Objective</h3><p>To present the clinical case of a severe phase of mania suffering from a possible Neuroleptic Malignant Syndrome (NMS).</p></div><div><h3>Clinical case</h3><p>16-year-old girl, native of Spain, family of Algerian background. Diagnosed with bipolar disorder. In the current episode, she begins a psychopathological decompensation after abandoning psychopharmacological treatment. She presents agripnia, irritability, escapes from home, expansive mood, as well as behavioral alterations rejecting any practice of her Islamic culture. Due to all this, she needs an involuntary admission to the hospitalization unit. During this, due to serious behaviors, mechanical and pharmacological restraint is required. Suddenly she begins to develop fever, generalized tremor and increased CPK in blood tests, which led to her transfer to the ICU for observation and intensive treatment due to the possibility of NMS.</p></div><div><h3>Results</h3><p>After stabilization, discharged was decided with a diagnosis of possible NMS and respiratory infection, with evident clinical improvement.</p></div><div><h3>Conclusions</h3><p>There are no universal criteria for NMS, the patient presents several typical symptoms but it is not possible to confirm that we are before a NMS in its totality. Socio-cultural aspects modulate psychopathology in a characteristic way.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116116023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.psiq.2021.100347
Javier Vilches Vázquez , Jose Manuel Gallego Rodríguez
Introduction
Parkinson's disease (PD) frequently presents as a complication with the presence of psychotic symptoms.
Objective
To describe the therapeutic process of PD-related psychotic symptoms, evaluating possible pharmacological alternatives.
Clinical case
A 41-year-old woman with early diagnosis of PD (diagnosed at an early age), poor response to dopaminergic treatment, with the presence of psychotic symptoms and the need for a deep brain stimulator. The patient was admitted due to new onset of psychotic symptoms while on low-dose levodopa.
Result
After poor response to treatment with clozapine, cariprazine was tried with improvement of symptoms, good tolerability, and no side effects.
Conclusions
Cariprazine may be an alternative in the event of clozapine treatment failure.
{"title":"Cariprazina como alternativa farmacológica en el tratamiento de la psicosis en la enfermedad de Parkinson","authors":"Javier Vilches Vázquez , Jose Manuel Gallego Rodríguez","doi":"10.1016/j.psiq.2021.100347","DOIUrl":"10.1016/j.psiq.2021.100347","url":null,"abstract":"<div><h3>Introduction</h3><p>Parkinson's disease (PD) frequently presents as a complication with the presence of psychotic symptoms.</p></div><div><h3>Objective</h3><p>To describe the therapeutic process of PD-related psychotic symptoms, evaluating possible pharmacological alternatives.</p></div><div><h3>Clinical case</h3><p>A 41-year-old woman with early diagnosis of PD (diagnosed at an early age), poor response to dopaminergic treatment, with the presence of psychotic symptoms and the need for a deep brain stimulator. The patient was admitted due to new onset of psychotic symptoms while on low-dose levodopa.</p></div><div><h3>Result</h3><p>After poor response to treatment with clozapine, cariprazine was tried with improvement of symptoms, good tolerability, and no side effects.</p></div><div><h3>Conclusions</h3><p>Cariprazine may be an alternative in the event of clozapine treatment failure.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128123905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-01DOI: 10.1016/j.psiq.2021.100337
Joana Isabel Gonçalves Cerejeira, Óscar Martín-Santiago, María del Pilar del Valle López
Schizophrenia is associated with certain structural brain alterations, some of them very rare, such as periventricular grey matter heterotopia. It consists of the presence of ectopic grey matter foci and results from a defect in neuronal migration towards the cerebral cortex during neurodevelopment. We present the cases of 2 patients with a family history of psychotic disorders diagnosed of First Episode Psychosis. In both patients, periventricular grey matter foci were found through brain MRI. Both cases show that early brain abnormalities may be involved in the pathogenesis of schizophrenia and these findings support the neurodevelopmental model.
{"title":"Heterotopia de sustancia gris en 2 casos de primeros episodios psicóticos","authors":"Joana Isabel Gonçalves Cerejeira, Óscar Martín-Santiago, María del Pilar del Valle López","doi":"10.1016/j.psiq.2021.100337","DOIUrl":"https://doi.org/10.1016/j.psiq.2021.100337","url":null,"abstract":"<div><p>Schizophrenia is associated with certain structural brain alterations, some of them very rare, such as periventricular grey matter heterotopia. It consists of the presence of ectopic grey matter foci and results from a defect in neuronal migration towards the cerebral cortex during neurodevelopment. We present the cases of 2 patients with a family history of psychotic disorders diagnosed of First Episode Psychosis. In both patients, periventricular grey matter foci were found through brain MRI. Both cases show that early brain abnormalities may be involved in the pathogenesis of schizophrenia and these findings support the neurodevelopmental model.</p></div>","PeriodicalId":39337,"journal":{"name":"Psiquiatria Biologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90030924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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