A cross sectional study of prevalence of depression among patients with cerebrovascular accident

Background: Depression is one of the most common neuropsychiatric condition in patients with stroke. Early identification of depression for stroke patients can improve the outcome leading to better quality of life. Prevalence and determinants of post stroke depression are highly variable and there is paucity of data in Indian literature.Methods: This cross-sectional study was conducted at neurology department of Saveetha Medical College, Chennai. All patients with history of stroke within past one month attending neurology department who fulfilled the inclusion criteria were taken up for the study after getting consent. Neurological examination and CT brain findings were noted with the site of lesion. All patients were evaluated for depression using ICD 10 criteria. MADRS score was used to assess the severity of depression. Chi square was used for statistical analysis.Results: The mean age of subjects in the study was 56.54±10.82 years. The prevalence of depression among patients with stroke in our study was 75.8%. Among classifying those with depression based on severity using MADRS score, 35% had mild depression and 65% had moderate depression. There was no severe depression in our sample. There was no statistically significant difference between prevalence of depression based on side of lesion.Conclusions: In this study the prevalence of depression among patients with cerebrovascular accident was found to be 75.8%. From this study we learn that the prevalence of depression in patients with stroke is high and this shows that regular screening of patients with stroke for depression might help in earlier detection and management of depression.

Oneroid syndrome: a rare form of psychosis

Oneiroid syndrome (OS) or dream-like fantastic delusional derangement of consciousness, is characterized by a kaleidoscopic quality of psychopathological experiences, wherein reality, illusions and hallucinations are merged into one. This syndrome is an uncommon psychiatric condition, which hardly finds any mention in psychiatric literature. Also, does not find a place in the current diagnostic systems. Here, we describe a rare case of oneroid syndrome in a young adult who presented to our department and who responded well to anti psychotics.

A rare case report of oral prednisolone dependence in a middle aged man

Dependence is an uncommon, but potentially sinister complication of corticosteroid therapy. prednisolone was the most frequently implicated corticosteroid in steroid dependence. Here we report a rare case of oral prednisolone dependence in middle aged man  who had chronic asthma.

Pseudoseizures with urinary incontinence in a child with Neuromyelitis optica: a rare association

Background: Paroxysmal non epileptic events or pseudoseizures are common seizure mimics in children. But occasionally PNES events can present or coexist along with organic neurological disorders complicating the clinical scenario posing great challenges for diagnostic and therapeutic implications. Unusual symptomatology in PNES like frothing, tongue bite or urinary incontinence can be seen in PNES. Here, we present a rare case of pseudoseizures with urinary incontinence in a child with Neuromyelitis optica which posed a challenge for diagnosis and proper management with a favourable clinical outcome. A 14 years old girl who was known diagnosed case of Neuromyelitis optica on treatment with oral steroids presented with a history of repeated attacks of involuntary movements affecting all four limbs preceded by a feeling of fear and pain and these events were associated with urinary incontinence. Electroencephalogram and magnetic resonance imaging were performed on the patient. Ictal video EEG confirmed the diagnosis of pseudoseizures. Neuropsychological evaluation was performed which revealed multiple psychological stressors. Repeated counseling sessions and psychotherapy provided significant improvement in the form of remission of pseudoseizures.