Progressive nonfluent aphasia with dementia: a case report.

We report a patient with progressive nonfluent aphasia and mild dementia. On 9-month follow-up evaluation, there was significant deterioration in both language and cognition. Unlike in Alzheimer's disease, the aphasia was of the Broca's type. In contrast with primary progressive aphasia, a dementia was present and the cognitive and language decline showed a rather rapid course.     

Fronto-temporal dementia: case report

Frontotemporal dementia is a relatively common form of primary dementia. The article presents a case of a female patient with probably inherited frontotemporal dementia, originally diagnosed as Alzheimer's disease.     

Stiff-person syndrome associated with invasive thymoma: a case report.

We report a case of a 40-year-old female with continuous muscle stiffness and painful muscle spasms. The symptoms worsened over a two-week period after onset. Electrophysiological examinations revealed continuous muscle discharge, which was markedly reduced by intravenous administration of diazepam. High levels of anti-glutamic acid decarboxylase (GAD) antibodies were detected in both serum and cerebrospinal fluid, suggesting that the patient suffered from stiff-person syndrome. Steroid pulse therapy and immunoadsorption therapy alleviated the clinical symptoms and decreased the anti-GAD antibody titer. A chest CT revealed the presence of an invasive thymoma. Neither anti-acetylcholine receptor (AChR) antibodies nor symptoms of myasthenia gravis (MG) were observed. The patient underwent a thymectomy and postoperative radiotherapy. These treatments further alleviated the clinical symptoms. The present case is the first that associates stiff-person syndrome with invasive thymoma, and not accompanied by MG. The autoimmune mechanism, in this case, may be triggered by the invasive thymoma.     

Trichotillomania and the mourning process: a case report and review of the psychodynamics

We present our theory of trichotillomania (hair pulling) as a manic phenomenon, complementary to its classic comprehension as a mourning response. Under certain conditions, separation or threat of separation can generate sadness or grief, while in pathological cases, when the loss is experienced as unbearable, the response might be depressive or manic. We suggest that in trichotillomania (TR), like in mania, manic defenses are used to cope with separation. We believe hair pulling is an expression of primary magical thinking, offering the subject an illusion of control and victory over the object. A representative case of a young woman suffering from bipolar disorder with TR is described. Based on our case analysis, we argue that TR may not necessarily be a variant of OCD, but rather classified among the affective disorders.     

Hair loss associated with paroxetine treatment: a case report.

Alopecia and hair loss are rare side effects of psychotropic drugs. There are a few case reports on hair loss associated with tricyclic antidepressants and serotonin selective reuptake inhibitors (SSRIs), but none deal specifically with paroxetine. We report on a 37-year-old female who complained of moderate hair loss during paroxetine treatment. Findings on discontinuation and rechallenge supported the assumption that the hair loss was a side effect of the paroxetine. Further investigation is needed to determine the scope of this troubling side effect.     

Sneddon's syndrome associated with anticardiolipin antibody: a case report.

We report the case of a young man suffering from the rare combination of livedo reticularis and recurrent ischemic cerebrovascular disease (Sneddon's syndrome). He also had a circulating anticardiolipin antibody. in the absence of systemic lupus erythematosus, we suggest the likelihood of a primary antiphospholipid syndrome.     

Seronegative dementia paralytica: report of a case

Dementia paralytica may present diagnostic difficulties when routine serological test using a non-treponemal antigen is non-reactive. We present an illustrative demented patient who initially had negative VDRL test both in his serum and cerebrospinal fluid. However, the brain biopsy specimen showed active meningoencephalitis. By special staining technique, a spiral organism was found in the brain exhibiting morphology perfectly compatible with treponema pallidum. Later in the course, the VDRL became reactive in the blood but remained non-reactive in the cerebrospinal fluid. On the basis of the experience of other workers in the field and ours with this patient, we advise the use of FTA-ABS test as a screening procedure in patients with neurological problems of possible syphilitic origin. We urge further research in this field.     

Priapism associated with iloperidone: a case report

Priapism is a known side effect of antipsychotics. The causal mechanism seems to be mediated through α1-adrenergic receptor blockade which many antipsychotics are known to possess. We present the first detailed case of iloperidone-induced priapism in a patient with bipolar disorder with psychotic features. His case highlights some of the important risk factors clinicians should consider when using iloperidone, as it may be the highest-risk antipsychotic for causing priapism given it is a very potent blocker of the alpha-adrenergic receptor.     

Amnestic syndrome associated with propranolol toxicity: a case report.

An elderly woman developed an Alzheimer-like subacute dementia as a result of propranolol toxicity. Analysis of the manifestations showed that severe impairment of memory accounted for virtually all of the abnormalities. There is evidence that cerebral reactions to drug toxicity can exhibit patterns that suggest highly selective involvement of functional subdivisions of the brain.     

Pseudohallucinations associated with moclobemide: a case report

The goal of the multicenter drug surveillance project AMSP ("Arzneimittelsicherheit in der Psychiatrie") is the monitoring, assessment and analysis of adverse drug reactions (ADR) of psychopharmalogical drugs. We report about a 23 year-old patient with a depressive episode. He developed severe pseudohallucinations under a treatment with moclobemide. The symptoms occur 6 days after starting the medication and decline within two days after stopping moclobemide. The term "pseudohallucinations" is discussed controversially but still of high interest.     

Thalamic dementia: report of a case with unusual lesion location

Thalamic dementia usually results from a bilateral paramedian thalamic infarction. We report a case with typical clinical and neuropsychological features of thalamic dementia, but with CT evidence of an unusual and asymmetrical location of ischemic lesions. Somatosensory evoked potential recordings were consistent with a left medial thalamic infarction, associated with a contralateral lesion, possibly at lemniscal level. This case suggests that thalamic dementia may develop following a unilateral paramedian thalamic infarction

---

Sommario La sindrome di demenza talamica è generalmente attribuita ad infarti talamici paramediani bilaterali. Riportiamo un caso con gli aspetti clinici e neuropsicologici della demenza talamica, ma con dimostrazione alla tomografia computerizzata di un'atipica ed asimmetrica distribuzione delle lesioni ischemiche: la registrazione dei potenziali somestesici ha confermato l'esistenza di una lesione talamica paramediana sinistra, associata ad una lesione controlaterale, verosimilmente lemniscale. Questo caso suggerisce che la sindrome di demenza talamica può far seguito ad una compromissione talamica paramediana unilaterale.

     

Trichotillomania in youth: a retrospective case series

Background: The purpose of this study was to investigate the outcome of the naturalistic treatment of youth with Trichotillomania (TTM) in an anxiety disorders clinic sample. Methods: A retrospective chart review was conducted on 11 treated patients between the ages of 6 and 17, with DSM‐IV TTM. Results: Ten patients were initially treated with a serotonin reuptake inhibitor (SRI), whereas one patient was initially treated with an antipsychotic. Three of the 10 patients who started with an SRI had a response (Clinical Global Impression‐Improvement Scale (CGI‐I)≥2) in TTM symptoms. Nine patients of the 11 patients were treated with an antipsychotic medication (in 8 patients the antipsychotic was added after an initial trial with an SRI, in 1 patient the antipsychotic was the first line agent), 2 patients remained on an SRI; 8/9 were responders to antipsychotic treatment and 2 patients remitted (complete cessation of hair pulling). Adverse events to the SRI or antipsychotic were experienced by 7/11 patients but did not lead to treatment discontinuation. Conclusions: This retrospective case series suggests that youth with TTM maybe responsive to pharmacological interventions with SRIs and/or antipsychotic agents, although the response seemed to be more robust with antipsychotics. These preliminary findings will need to be replicated in a larger scale controlled design. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.     

Encephalitis associated with herpes zoster: a case report and review.

This paper describes the case of a patient with a history of affective disorder who developed encephalitis associated with herpes zoster which presented as a delirium with prominent manic symptoms. Published reports of encephalitis following herpes zoster infections are reviewed. The diagnosis of herpes zoster-associated encephalitis should be suspected in individuals with changes in his or her mental state, an abnormal electroencephalogram and an abnormal cerebrospinal fluid examination which closely follow a cutaneous herpes zoster lesion.     

Paraneoplastic limbic encephalitis associated with bronchogenic carcinoma: a case report.

Paraneoplastic limbic encephalitis is a rare clinical entity, associated most often with the oat cell carcinoma of the lung. Clinically, it presents with affective changes in personality, memory loss, confusional state, hallucinations, and seizures; with dementia being the common feature as the disorder progresses. Response to treatment is disappointingly poor.