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Real Doctors (Life Makers)  |  Clinical  |  Psychiatry , Pyschology and Behavioral Medicine  |  Organic psychosis « previous next »
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Author Topic: Organic psychosis  (Read 7168 times)
dr_b.e.s.m
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Organic psychosis
« on: /November/ 10, 2005, 04:41:32 PM »

A 25 years male presented to Psychiatry OPD with symptoms of restlessness, irritability, and episodic anger outburst, delusions of reference and persecution, auditory and visual hallucinations (hearing divine voices and seeing snakes/fires, etc.) and disturbed sleep for a period of about one year. On exploration, he gave history of severe headache off and on, for which he was treated at local hospital with analgesics. His behavioural symptoms aggravated for last two months for which he was brought to Psychiatry OPD and diagnosis of psychosis NOS (ICD-10) was made.

----> Treatment commenced with a combination of novel antipsychotic risperidone 4 mg/day and clonazepam 2 mg/day.
---> His psychotic symptoms improved partially over a period of 4 weeks but developed headache followed by generalized tonic-clonic seizures and presented to Medical OPD. On examination he was drowsy and was responding inappropriately to some of the commands and had multiple
subcutaneous nodules. Rest of the examination was normal.

- Haemogram showed slight eosinophilia (5%).
- X-ray right upper limb showed multiple calcified spots (Fig. 1).
- CT scan brain revealed multiple calcified and hypodense lesions with surrounding oedema (Fig. 2).

---->? He was put on tab phenytoin sodium 300 mg OD, inj mannitol along with prednisolone 40 mg OD.

- Histopathological examination of biopsy from subcutaneous nodule confirmed the diagnosis of cysticercosis.
- During hospital stay his psychotic symptoms worsened and he was found to have mixed psychotic and affective (depressive) symptoms along with extrapyramidal symptoms. --->? He was put on olenzapine 10 mg/day with venlafaxine 75 mg/day. He was continued on anticonvulsants, antipsychotic and steroids were tapered off over next six weeks.

---> He was free of seizures and psychiatric symptoms on follow up visits at eight weeks and six months.

* ct.JPG (22.03 KB - downloaded 18 times.)
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musheera
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Re: Organic psychosis
« Reply #1 on: /November/ 14, 2005, 03:24:21 AM »

thanks for the very intresting post!!
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dr_b.e.s.m
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Re: Organic psychosis
« Reply #2 on: /November/ 17, 2005, 02:00:35 PM »

Thank you Dr Musheera , I am glad you found this post interesting.

Actually we saw a similar case in our hospital about 4 months ago , but it was due to hydatid disease of the brain. I will see if the clinical data and investigations are still available in the hospital so I can post it here insha`allah.

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