过敏性精神病伴急性肌张力障碍。

Tatiana Nunez, Gabriella Meyerson, Mays Alani, Shahid Elahi, Enrique Vargas
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引用次数: 1

摘要

简介:超敏感性精神病是伴随抗精神病药物长期使用而继发于治疗耐药性的一种现象。目前,对于超敏感性精神病的治疗还没有标准化的指导方针。病例介绍:我们报告了一例患有分裂情感性障碍的患者,他在停止使用包括高剂量喹硫平和奥氮平在内的精神药物后出现了超敏感性精神病和急性肌张力障碍。患者表现出过度焦虑、偏执、怪异想法和影响面部、躯干和四肢的广泛性肌张力障碍。经奥氮平、丙戊酸、地西泮治疗,患者精神症状恢复至基线,肌张力障碍明显改善。尽管依从,但由于抑郁症状和肌张力障碍恶化,患者再次住院稳定。在第二次入院时,患者需要进一步修改精神药物并补充电休克治疗。结论:本文讨论了超敏性精神病的治疗方案,包括电休克治疗在缓解超敏性精神病及相关运动障碍中的作用。我们希望扩大对超敏性精神病中其他神经运动表现的认识,以及对这种独特表现的处理。
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Supersensitivity Psychosis with Acute Dystonia.

Introduction: Supersensitivity psychosis is a phenomenon that occurs with chronic usage of antipsychotics secondary to treatment resistance. At this time, there are no standardized guidelines regarding the management of supersensitivity psychosis.

Case presentation: We present a case of a patient with schizoaffective disorder who developed supersensitivity psychosis and acute dystonia in response to discontinuing psychotropic medications, including high-dose quetiapine and olanzapine. The patient presented with excessive anxiety, paranoia, bizarre thoughts, and generalized dystonia affecting the face, trunk, and extremities. We treated the patient with olanzapine, valproic acid, and diazepam, which alleviated the psychosis back to baseline and significantly improved the dystonia. Despite compliance, the patient returned for inpatient stabilization due to depressive symptoms and worsening of the dystonia. During the second admission, the patient required further modification of psychotropics and supplemental electroconvulsive therapy.

Conclusion: In this paper, we discuss the proposed treatment of supersensitivity psychosis, including the role that electroconvulsive therapy may play in alleviating supersensitivity psychosis and associated movement disorders. We hope to expand the knowledge of additional neuromotor manifestations in supersensitivity psychosis and the management of this unique presentation.

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