[The case of a 86-years old woman first diagnosed with Huntington's disease]. / Erstdiagnose einer Huntington-Krankheit bei einer 86-jährigen Patientin.

This is the rare case of a woman first diagnosed with Huntington's disease at the age of 86. She was first seen at our hospital in 1999 for evaluation of dementia. Prior to her hospitalization, she had been treated with Melperone for restlessness. There was no essential psychopathology other than mild dementia (MMSE 21). A neurological work-up identified generalized involuntary movements and genetic testing revealed 40 CAG repeats. Over the course of the next several years, the patient began to exhibit the full range of symptoms associated with Huntington's disease, such as severe involuntary movements and progressive dementia. In the end, she was bed-ridden and only able to utter a few unintelligible words and she succumbed to an infection in 2003 at the age of 89, almost 4 years after her initial diagnosis of Huntington's disease. This case points to the need to consider Huntington's disease as a differential diagnosis even when evaluating the geropsychiatric population. It is particularly important to isolate involuntary movements which cannot be attributed to tardive dyskinesia in those who have been treated with neuroleptics in the past.

[Pseudophaeochromocytoma in a Patient with Parkinson's Disease and Depression] / Pseudophäochromozytom bei M. Parkinson und Depression.

We report the case of a 62-year-old woman with parkinson's disease and depression. Her symptoms included episodes of flushing, palpitations and hypertension, giving rise to the suspicion of the existence of a phaeochromocytoma. The levels of adrenaline and vanillymandelic acid in the urine were moderately elevated, the noradrenaline level was high- normal. Upon further examination, there was no evidence of a phaeochromocytoma or a carcinoid tumor. In the literature, there are reports of pseudophaeochromocytoma in patients receiving levodopa. Elevated levels of catecholamins and their metabolites can be caused by the metabolic process of levodopa and levodopa can influence the outcome of laboratory tests. The patient's depression resolved and the flushing disappeared after treatment with antidepressants and after changing the Parkinson regime.

[Schizophreniform Psychosis in a Patient with Right Temporal-parietal Meningioma] / Schizophreniforme Psychose bei temporoparietalem Meningeom rechts.

We report the case of a 64-year-old woman with a right temporal-parietal meningioma. She presented initially with depressive symptoms but later developed symptoms of acute schizophreniform psychosis. The psychotic symptoms dissapeared after treatment with neuroleptics. The resection of the meningioma led to a lasting remission of the psychotic symptomatology without continued administration of neuroleptics. The correlation between psychotic symptoms and the results of CT scan or MRI is controversial. In this case, the evidence points towards an organic cause of the psychosis rather than an endogenous psychosis.

[Subacute Sclerosing Panencephalitis Presenting Initially as Schizophrenic Psychosis in a 19-Year Old Man] / Paranoid-halluzinatorische Psychose als Erstmanifestation einer subakuten sklerosierenden Panenzephalitis (SSPE) bei einem 19-jährigen Mann.

We report the rare case of a 19-year old man, first diagnosed with schizophrenia but finally shown to have subacute sclerosing panencephalitis (SSPE). Initial symptoms were hallucinations and negative symptoms until the onset of a seizure. Changes in the CSF, MRI, EEG and increasing neurological symptoms led to the correct diagnosis of subacute sclerosing panencephalitis. The EEG results were of particular importance as they already showed the characteristic changes, even while the patient still only presented with psychotic symptoms. This case report demonstrates the importance of ongoing neurological examinations in patients with psychiatric disorders. In the literature, there are only three case reports about children (8, 9 and 10 year old) as well as one of a 21-year old women with subacute sclerosing panencephalitis presenting with psychosis.

[Pseudopheochromocytoma in Parkinson disease and depression]. / Pseudophäochromozytom bei M. Parkinson und Depression.

We report the case of a 62-year-old woman with parkinson's disease and depression. Her symptoms included episodes of flushing, palpitations and hypertension, giving rise to the suspicion of the existence of a phaeochromocytoma. The levels of adrenaline and vanillymandelic acid in the urine were moderately elevated, the noradrenaline level was high-normal. Upon further examination, there was no evidence of a phaeochromocytoma or a carcinoid tumor. In the literature, there are reports of pseudophaeochromocytoma in patients receiving levodopa. Elevated levels of catecholamins and their metabolites can be caused by the metabolic process of levodopa and levodopa can influence the outcome of laboratory tests. The patient's depression resolved and the flushing disappeared after treatment with antidepressants and after changing the Parkinson regime.

[Paranoid-hallucinatory psychosis as primary manifestation of subactue sclerosing panencephalitis (SSPE) in a 19-year-old man]. / Paranoid-halluzinatorische Psychose als Erstmanifestation einer subakuten sklerosierenden Panenzephalitis (SSPE) bei einem 19-jährigen Mann.

We report the rare case of a 19-year old man, first diagnosed with schizophrenia but finally shown to have subacute sclerosing panencephalitis (SSPE). Initial symptoms were hallucinations and negative symptoms until the onset of a seizure. Changes in the CSF, MRI, EEG and increasing neurological symptoms led to the correct diagnosis of subacute sclerosing panencephalitis. The EEG results were of particular importance as they already showed the characteristic changes, even while the patient still only presented with psychotic symptoms. This case report demonstrates the importance of ongoing neurological examinations in patients with psychiatric disorders. In the literature, there are only three case reports about children (8, 9 and 10 year old) as well as one of a 21-year old women with subacute sclerosing panencephalitis presenting with psychosis.