Esquizencefalia de labio cerrado bilateral: a propósito de un caso / Schizencephaly of bilateral closed lip: speaking of one case

La esquizencefalia es un desorden de la migración neuronal, caracterizada por hendiduras de sustancia gris en los hemisferios cerebrales que se extienden desde la superficie pial a los ventrículos laterales. Esta patología es el resultado final de una amplia variedad de factores genéticos, tóxicos, metabólicos y de agentes infecciosos que ocurren durante un período crítico del desarrollo cerebral. Esta malformación puede ser unilateral o bilateral y puede ser dividida en dos subtipos: de ¨labios cerredos" o tipo I, o de "Labios abierto" o tipo II. Presentamos el caso de una paciente demenina de 37 años de edad con epilepsia y hallazgos neurorradiológicos de esquizencefalia de "labios cerrados" bilateral

Schizencephaly is a rare developmental of neuronal migration, characterized by congenital clefts spanning the cerebral hemisphere from the pial surface to the lateral ventricle and lined by cortical gray matter. The lesion is the final result of a variety of etiologies including genetic, toxic, metabolic and infectious agents during a critical period of the development of the brain. This malformation can be unilateral or bilateral and may be divided in two subtypes: "closed tips" or type I and "open tips" or type II. We present 37 years old female patient with epilepsy and neuroradiological findings of bilateral "closed lips" schizencephaly

Controlled study on therapeutic effects of electroacupuncture and modified electric convulsive therapy on catatonic schizophrenia / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the clinical therapeutic effect of electroacupuncture for treatment of catatonic schizophrenia.</p><p><b>METHODS</b>Eighty cases were randomly divided into an observation group and a control group, 40 cases in each group. The observation group was treated with electroacupuncture, Baihui (GV 20) and Taiyang (EXHN 5) were selected, once daily; the control group was treated with modified electric convulsive therapy (MECT), the treatment was given once every 2 days or 3 days, 14 to 21 days constituted one course in the two groups.</p><p><b>RESULTS</b>The markedly effective rate and total effective rate were 72.5% and 92.5% in the observation group, 77.5% and 97.5% in the control group, respectively, there was no significant difference between the two groups (both P>0.05).</p><p><b>CONCLUSION</b>The therapeutic effect of electroacupuncture is similar to that of MECT.</p>

A Case of Catatonic Schizophrenia Associated With Proximal Interphalangeal Joint Flexion Contracture in Non-Dominant Hand / 신경정신의학

OBJECTIVES: Psychogenic contractures in the hand are a rare topic in the medical literature and psychoflexed hand is rarely mentioned even in orthopedic textbooks. By reporting a case with classic catatonic features of the catatonic type of schizophrenia associated with proximal interphalangeal joint flexion contracture in non-dominant hand, the existence of this rare and almost unknown entity is emphasized and the diagnostic and therapeutic importance facing the clinicians dealing with psychological related symptomatology is suggested. CASE: A 54-year-old, single, right-handed woman who lived alone presented to emergency department in catatonic stupor state, severe dehydration due to refusal of oral intake for about 15 days. She had received a diagnosis of schizophrenia, catatonic type at age 33 and had been hospitalized with catatonic motor and behavioral symptoms for a long time. She was hospitalized in medical intensive care unit and abnormal results of laboratory studies at admission including hypernatremia due to severe dehydration, prerenal azotemia, and hemoconcentration was corrected. Catatonia was confirmed by CRS Catatonia Rating Scale (CRS). Her catatonic and other psychotic symptoms began to resolve with treatment, but the patient was found to have had the psychogenic hand deformity characteristics of proximal interphalangeal joint flexion contractures of left 2nd, 3rd, 4th, 5th finger which started about 20 years ago. She allowed us to try to have a appropriate diagnostic evaluation but as she had experienced a full resolution of catatonic and other psychotic symptoms, she began to resist all the orthopedic treatments. She was discharged by caregiver's request because of economic problems. CONCLUSION: This case highlights the importance of having specific and systemized medical workups for catatonia of schizophrenia in order to prevent the sequelae of severe psychopatholgy such as flextion contractures and other potential complications.

Catatonic Syndrome – A Review.

Catatonia is common in clinical practice, though prevalence of affected patients has decreased over time. It is a syndrome with varies etiologies. Causative factors range from schizophrenia, depression, drug induced adverse effects to organic causes. It may present in two forms: stuporous and excited. Schizophrenia is thought to the most common cause, however, evidence suggest that it is more common in depression. Successful treatment of catatonia with lorazepam supports it.

Catatonía: Un sindrome neuropsiquiátrico / Catatonia: A Neuropsychiatric Syndrome

La catatonía es un síndrome neuropsiquiátrico caracterizado por anormalidades motoras, que se presentan en asociación con alteraciones en la conciencia, el afecto y el pensamiento. Inicialmente, Kahlbaum describió el síndrome, en 1868, cuando observó pacientes que padecían una condición de ®profunda melancolía¼. En 1893, Kraepelin limita la catatonía a un subtipo de demencia precoz, pero posteriormente fue redefinida por Bleuler, en 1906, como esquizofrenia de tipo catatónico. Desde entonces, se ha hecho cada vez más evidente su relación con patologías etiológicas, fuera de los límites de la esquizofrenia y los trastornos del afecto, lo que ha llevado a ampliar su categoría en la clasificación de los trastornos mentales (DSM-IV), para incluir estas otras patologías asociadas. Este artículo pretende revisar los conceptos actuales sobre el síndrome, a partir de datos históricos, definición, causas etiológicas, neurofisiopatología, criterios diagnósticos y tratamiento...

Periculosidade e responsabilidade penal na esquizofrenia / Dangerousness and penal imputability in schizophrenia

O presente trabalho, por meio de uma revisão de literatura, faz um breve estudo sobre os conceitos de periculosidade e responsabilidade penal na esquizofrenia. É apresentado um relato de caso de uma paciente esquizofrênica que cometeu homicídio e recebeu como sentença judicial a aplicação de medida de segurança detentiva

Catatonia due to different causes; case series

Catatonia is a serious and fascinating syndrome. It calls for diagnostic rigor and knowledgeable treatment on the part of the Physician and sometimes the Surgeon. Both of them seek to reattach their catatonic patients to their community from which these patients were separated. Kahlbum attributed the condition to organic cerebral disease. In this article we mentioned six cases of catatonia due to different causes including schizophrenia, depression, hyperparathyroidism, central pontine and extrapontine myelinolysis [due to overrapid correction of hyponatremia], carbon monoxide poisoning and systemic lupus erythematosis. All these cases presented by catatonia and number of different medical specialties shard in their diagnosis and treatment. Really, catatonia is a unique syndrome in which we stand to gain valuable insight into how motivation and movement are mediated in the brain

Ganho de peso e medicações antipsicóticas / Weight gain and antipsycotics

Desde sua introdução no mercado, os antipsicóticos têm sido relacionados a aumento de peso. O advento dos antipsicóticos de nova geração trouxe avanços significativos no tratamento dos quadros esquizofrênicos tanto em relação à sintomatologia negativa, depressiva e cognitiva quanto em relação à segurança e tolerabilidade. No entanto, o ganho de peso ainda se mantém como um evento adverso frequente nesta classe. As autoras apresentam um breve resumo da literatura sobre o ganho de peso associado à terapia antipsicótica e seus possíveis mecanismo de ação. Descrevem ainda estratégias cognitivo-comportamentais e farmacológicas para o manejo do ganho de peso para os pacientes em uso de medicações antipsicóticas.

Transtornos mentais e comportamentais em servidores da Universidade Federal do Paraná-UFPR / Mental disorders and behavior in Parana Federal University's workers

Este trabalho tem o objetivo de responder à pergunta: quais os distúrbios mentais encontrados com maior frequüência em servidores da UFPR? Para respondê-la, no primeiro momento, realizou-se a fundamentaçäo teórica, buscando na história o sentido da intervençäo humana no mundo pelo trabalho. Foram destacados alguns aspectos atuais de como o trabalho é organizado nas empresas e o que contribui negativamente para a saúde mental dos trabalhadores. No segundo momento do trabalho constatou-se que, do total de 71 trabalhadores (44 pacientes do sexo feminino e 27 pacientes do sexo masculino), da amostra de 376 funcionarios, selecioandos aleatoriamente do total de 5.550 trabalhadores da UFPR, as maiores ocorrências patológicas, em homens e mulheres conjuntamente, foram observadas no que diz respeito aos transtornos de humor afetivo, tipos: maníacos, depressivo, bipolar (F30-F39) (64,34 por cento). Em segundo lugar se fizeram presentes as ocorrências de transtornos neuróticos, esquizofrenias do tipo: fóbico, ansiedade, compulsivo, neusrastênico (F40-F49) (8,6 por cento). Separadamente, houve maior número de ocorrências de transtornos de humor afetivo em mulheres (67,50 por cento), do que em homens (57,14 por cento). Quanto aos transtornos neuróticos, transtornos de relacionamento com o streess e somatoformes, houve maior número de ocorrências em homens (28,57 por cento), do que em mulheres (22,50 por cento), o mesmo acontencendo com as ocorrências de esquizofrenia, transtornos esquizotípicos e delirantes, maior número constatado em homens (11,42 por cento), do que em mulheres (7,50 por cento). Os transtornos F00-F009, F20-F20 e F90-F99 tiveram ocorrências menores. O conjunto desses dados torna o trabalho significativo por indicar a necessidade de melhoria da qualidade de vida do trabalhador de UFPR

Complexidade do diagnostico diferencial em psiquiatria: relato de sindrome catatonita / The complexity of the differential diagnosis in psychiatry exemplified by a catatonic syndrome

Os autores relatam um caso de sindrome catatonica que evoluiu com afasia apos um provavel episodio infeccioso do sistema nervoso central (encefalite viral?), que nao foi confirmado por exames complementares...

Rating chronic: discrepancy between cross-sectional and longitunal assessment

A bush-Francis Catatonia Rating Scale (BFCRS) e o primeiro instrumento valido desenvolvido exclusivamente para a avaliacao da sindrome catatonica. Neste estudo, os autores investigaram a hipotese de que a BFCRS pode ser valida e confiavel para a avaliacao transversal de condicoes catatonicas agudas e cronicas, mas ela pode ser inferior a observacao clinica longitudinal para fornecer informacao sobre a severidade de fenomenos catatonicos em pacientes com esquizofrenia cronica...

Two Cases of Risperidone-Induced Mania in Schizophrenics / 신경정신의학

We report the first two cases of manic and hypomanic episodes respectively induced by risperidone treatment done to schizophrenics in Korea. One case was a 22-year-old woman with catatonic schizophrenia. Since 3 years ago, she had shown psychotic symptoms, but with was poor treatment compliance. She had mainly negative symptoms such as social withdrawal, decreased flood intake, mutism, and symptoms had been worsened since last 4-5 months. Prior to closed ward admission, she was prescribed 2mg/d of risperidone far a week at OPD. Two days after taking medicine totally 6-8mg, she revealed manic features. After hospitalization, risperidone was discontinued and then, lithium 900mg/d and high dosage of conventional antipsychotics(chlorpromazine 1200mg/d or haloperidol 20mg/d) were prescribed. About on the l0th day of hospitalization, there was limited improvement of her manic symptoms. The other case was a 29-year-old man with a 3-year history of paranoid schizophrenia. He was never exposed to antipsychotics before. His main symptoms were delusions of being poisoned and of persecution. His positive and also negative symptoms were alleviated by 38 days of risperidone 2mg/d trial. However, one week after dosage increment to 3mg/d, hypomanic symptoms appeared. Risperidone medication was discontinued and was replaced by chlorpromazine 300mg/d. The hypomanic episode was resolved over 5 days. In both of the two cases, manic episodes occurred by monotherapy of risperidone without mood stabilizer, and there were no history of substance abuse and other psychiatric disorders, family history of psychiatric disorders, and comorbid physical illnesses. It is hypothesized that the potent blockade effect on serotonin(5-HT2) receptor of risperidone causes antidepressant effect, as well as therapeutic effect for negative and affective symptoms in schizophrenia. Risperidone would induce manic or hypomanic features in schizophrenic patients. And there are few case reports of risperidone-induced mania or exacerbation of preexisting manic symptoms by risperidone treatment in mood disorder and schizoaffective disorder. Risperidone is being used more widely, even for obsessive-compulsive disorder and other psychiatric disorders. It is necessary for clinicians to recognize manic switch, one of psychiatric side effects by risperidon trial. It is recommended that the combination of mood stabilizer with risperidone or usage of the minimum effective dose of risperidone may bewefal especially in the patients with mood disorders or schizoaffective disorders. Clozapine which has mood-stabilizing properties is also beneficial in risk groups of risperidone-induced mania.

Opiniäo e conhecimento de pacientes e familiares sobre o uso da eletroconvulsoterapia: implicaçöes para a enfermagem / opinion and knowledge of patients and their relativies of the electroconvulsive therapy: implications for nursing

Neste trabalho verificou-se a opiniäo e o conhecimento de pacientes internados em uma unidade psiquiátrica e seus familiares, sobre a aceitaçäo do uso da eletroconvulsoterapia. Através de análise quantitiva constatou-se a aprovaçäo da maioria ao tratamento, apesar do escasso conhecimento sobre este, apresentado pelos indivíduos estudados. Constatou-se também que o conhecimento desse tratamento e a confiança depositada no profissional médico que indica o tratamento, parece influir na opiniäo dos indivíduos sobre seu uso. Desta forma existe a importância do papel do enfermeiro na educaçäo dos indivíduos em relaçäo à eletroconvulsoterapia.

Sintomatología afectiva y modelo piramidal de la esquizofrenia / Affective symptomatology and piramidal model of schizophrenia

Clásicamente se reconoce que síntomas afectivos forman parte del trastorno esquizofrénico. Recientemente Kay y colaboradores propusieron un modelo dimensional de esquizofrenia que incorpora la sintomatología afectiva. Este modelo de tipo piramidal, sugiere la existencia de síndromes no correlacionados, pero no excluyentes que dan cuenta del espectro de la sintomatología esquizofrénica. Los síntomas positivos, negativos y depresivos constituyen puntos divergentes de una base triangular, mientras que la excitación constituye un eje vertical separado.Los síndromes obtenidos pueden dar cuenta de los subtipos diagnósticos paranoide (positivo-depresivo), desorganizado (positivo-negativo) y catatónico (negativo-depresivo). Este modelo ayuda a clarificar la heterogeneidad de la esquizofrenia y orienta hacia la búsqueda de tratamientos más específicos

Esquizofrenia y homicidio: análisis de una década de informes médico legales / Schizophrenia and homicide: analysis of a decade of medical legal reports

Se analizan todos los informes psiquiátricos practicados por la unidad de psiquiatría del Servicio Médico Legal de Santiago en el período comprendido entre 1981 y 1991. Se seleccionan 42 informes correspondientes a esquizofrénicos homicidas en quienes se analizan las características psicopatológicas y demográficas comparando los resultados con lo publicado por la literatura. Hubo 35 hombres (83 por ciento) y 7 mujeres (17 por ciento). La mayoría de los hombres eran solteros (76 por ciento) y con estudios incompletos. Existe cercanía con la víctima en un 66 por ciento de los casos y de las 7 mujeres de la muestra 5 atentan contra un hijo. El 70 por ciento de los enfermos se encontraba sin tratamiento al momento del delito. El subtipo paranoide es el más frecuentemente involucrado

Wilson's disease with catatonic features

A case of Wilson's disease [Hepato-Lenticular Degeneration] in a 14 year old girl, was diagnosed on clinical grounds as Catatonic Schizophrenia. Psychiatric symptoms with motor abnormalities masquerading as Wilson's Syndrome are discussed. A screening test for Wilson's disease in psychiatric patients below the age of 40 presenting with neurological symptoms is strongly recommended