Recurrent Psychotic Depression Associated with Chronic Subdural Haematoma: A Case Report.

Chronic subdural hematomas (CSDH) with isolated psychiatric presentation are rare. In this paper, we report a case of 77-year-old-female patient who had psychotic depression after repetitive head trauma without any neurological symptoms. The brain magnetic resonance imaging revealed an 20 mm subdural hematoma in the right frontoparietal region and a 7 mm subdural hematoma in the left frontal region. The psychiatric symptoms improved within the first week after evacuation but relapsed with the occurrence of right sided pneumocephalus. In the follow up, with the disappearance of the pneumocephalus, the psychiatric symptoms improved. It should be kept in mind that isolated psychiatric symptoms can be seen due to subdural hematoma and evacuation of the hematoma has an important role in improving the psychiatric symptoms.

Catatonia Due to Lithium Neurotoxicity: A Case Report. / Lityum Nörotoksisitesine Ikincil Gelisen Katatoni Vakasi: Bir Olgu Sunumu.

Lithium may cause toxicity as it has a narrow therapeutic range. Lithium intoxication may manifest in the form of acute, acute on chronic and chronic intoxication. Neurotoxicity is a common component of chronic lithium intoxication and the symptoms include tremor, ataxia, dysarthria, extrapyramidal symptoms, hyperreflexia, seizures and status epilepticus. Although rare, catatonia could as a manifestation of lithium neurotoxicity. In this report, we present a patient with bipolar disorder presenting with catatonic symptoms secondary to lithium intoxication. We will discuss the risk factors, differential diagnosis and the treatment of catatonic symptoms. Lithium neurotoxicity may present with various clinical symptoms including catatonia, and differential diagnosis should be made well in such cases. If lithium neurotoxicity is suspected, rapid and appropriate intervention is required to prevent permanent neurological damage. Keywords: Lithium, Neurotoxicity, Catatonia.

Transient Fever Response After ECT in a Patient with Catatonic Schizophrenia: A Case Report. / Katatonik Sizofreni Hastasinda EKT Sonrasi Ortaya Çikan Geçici Ates Yaniti: Olgu Sunumu.

Electroconvulsive therapy (ECT) is an effective and safe treatment method for many psychiatric disorders. In general medical practice, ECT may cause side effects as most other treatment methods do. Headache, myalgia, nausea, vomiting, confusion, anterograde amnesia are common side effects of electroconvulsive therapy. Fever; in addition to general medical conditions such as infection, malignancy, connective tissue diseases, drug treatments, malignant hyperthermia, convulsions, it can also occur due to conditions such as neuroleptic malignant syndrome (NMS), serotonin syndrome, catatonia, malignant catatonia, which are frequently encountered in psychiatry clinics. In the literature, transient fever response due to electroconvulsive therapy application have been described, albeit rarely. Although there are many proposed mechanisms for the emergence of a fever response, regardless of its cause, it is still not understood why some fever responses occur. In this article, we present the differential diagnosis of the fever response, possible causes, and the mechanisms that may reveal the secondary fever response to electroconvulsive therapy in a case with a diagnosis of catatonic schizophrenia, who developed a fever response during electroconvulsive therapy sessions and no fever response was observed at times other than electroconvulsive therapy sessions. In this case, postictal benign fever response associated with electroconvulsive therapy was considered after excluding other medical conditions that may cause a fever response after electroconvulsive therapy. Keywords: ECT, Fever, Catatonia, NMS.

c.4168G>A(p.Ala 1390Thr) Variation in KMT2D Gene Detected in an Ultra-treatment-resistant Schizophrenia Patient: A Case Report and Literature Review.

Schizophrenia has a multifactorial etiology with a significant genetic component. Genome-wide association studies have identified common variants in candidate genes. However, the common variant can only account for a portion of the genetic variation underlying the disorder. Therefore, researchers suggest that rare variants may be one source of missing heritability in schizophrenia. We report the case of a 20-year-old male patient diagnosed with early-onset and ultra-treatment-resistant schizophrenia and mild intellectual disability and discuss certain rare genetic variants that may be involved in the etiology. He was hospitalized for the initiation of clozapine treatment and was referred to the department of genetics because he had macrocephaly, high arched palate, a prominent forehead, hearing impairment, and hyperpigmented skin lesions. The whole exome sequencing analysis revealed a heterozygous 4168G>A(p.Ala1390Thr) variant in exon 15 of KMT2D (Lysine N-Methyltransferase 2D) (NM_003482.4) gene, which is associated with Kabuki Syndrome. The variants in KMT2D have been reported to be associated with brain development and may play a role in schizophrenia. We discussed the relationship between schizophrenia and genetic variants detected in this case in light of the literature.

Relationship Between Sleep Disorders and Attention Deficit- Hyperactivity Disorder Symptoms in University Students. / Üniversite Ögrencilerinde Uyku Bozuklugu ile Dikkat Eksikligi Hiperaktivite Bozuklugu Belirtileri Arasindaki Iliski.

OBJECTIVE: Sleep disorders increase the symptoms of attention deficit hyperactivity disorder (ADHD). The aim of this study was to investigate whether or not sleep related problems give rise to symptoms of attention deficit and hyperactivity-impulsivity in university students. METHODS: The 252 university students between the ages of 18-25 years included in the study were assessed on the Pittsburgh Sleep Quality Index (PSQI), the Adult Attention-Deficit Hyperactivity Disorder Scale, the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). RESULTS: The participants of the study comprised 38.5% males and 61.5% females with a mean age of 22.39 (±1.93) years. The mean score data were 5.78 (± 2.72) on the PSQI, 41.77 (± 20.38) on the Adult Attention-Deficit Hyperactivity Disorder Scale, 8.53 (± 6.97) on the BDI and 9.05 (± 7.92) on the BAI. The total score and the scores on the attention-deficit and the general problems subsections of the Adult Attention-Deficit Hyperactivity Disorder Scale were significantly higher in participants with poor sleep quality (P<0.001). The PSQI and the Adult Attention-Deficit Hyperactivity Disorder Scale scores were significantly above the cut-off values in the participants with depression and anxiety symptoms as compared to those without these symptoms (P<0.001). The PSQI total score positively correlated with the Adult Attention-Deficit Hyperactivity Disorder Scale total score (P<0.001). CONCLUSION: University students with sleep disorder have more ADHD symptoms and poor quality of sleep increase ADHD sypmtoms. Therefore it's important to evaluate quality of sleep in young people suffering from attention problems in terms of treatment approaches and interventions.

Atypical Neuroleptic Malignant Syndrome Induced by Low Dose Quetiapine in a Patient Treated with Donepezil.

Neuroleptic malignant syndrome is a rare idiosyncratic drug reaction that causes morbidity and mortality. Although muscle rigidity and fever are accepted as major symptoms, there is no consensus on the diagnostic criteria. This flexibility in diagnostic criteria allows for the diagnosis of atypical cases. Keeping in mind that neuroleptic malignant syndrome may also occur with the use of low doses of atypical antipsychotics is important for making the diagnosis quickly and reducing the risk of morbidity and mortality. In this report, we aim to present a case with atypical neuroleptic malignant syndrome associated with the use of very low dose quetiapine and discuss the risk factors that facilitate its emergence.

Coincidental FCoincidental Feeding Artery Aneurysm Presenting during Glioblastoma Surgery: A Case Report and Literature Revieweeding Artery Aneurysm Presenting during Glioblastoma Surgery: A Case Report and Literature Review.

The medical literature reports an association between cerebral neoplasms and aneurysm formation. Some related aneurysms are detected during preoperative screening, whereas others are detected during or after surgery. We report a patient with de novo cerebral feeding artery aneurysm that we managed during glioblastoma surgery. We present a brief review of the literature on the coexistence of brain tumors, particularly that related to high-grade glioma and aneurysms. The literature discusses several mechanisms underlying tumor formation accompanied by aneurysm formation. Some classifications were also proposed for grouping such aneurysms. We question the necessity of the routine use of vascular imaging for patients with glioblastoma.