Confusion, dissociation and bizarre behaviour as the onset of an early Susac syndrome.

A 47-year-old woman presented an episode of confusion and disorientation. According to remarkable psychiatric records, she had been treated for major depression and obsessive-compulsive disorder; however, no other relevant background was known. After preliminary examinations, blood analysis and neurological tests were unspecific and inconclusive. Therefore, the case was treated as a possible psychiatric episode related to her previous psychiatric disorders. However, due to the atypical presentation of the case, a cerebral MRI was performed, which demonstrated multiple central lesions of the corpus callosum ('snowball lesions'), as well as several supratentorial white matter lesions. As a result of the follow-up of the case, sensorineural hearing loss and branch retinal artery were detected, which concluded in the classic triad and the confirmation of the diagnosis of a Susac syndrome.

La locura mixedematosa. El delirio que cura con levotiroxina / Myxoedema madness. The delusion that is cured with levothyroxine

Objetivo: El objetivo de este artículo es analizar, a través de un caso clínico, los trastornos psicóticos relacionados con el hipotiroidismo. Caso clínico: Se presenta el caso clínico de una mujer de 51años ingresada en el hospital por un trastorno psicótico agudo, con delirios paranoides y conducta alucinatoria. La evaluación revela un estado hipotiroideo severo y la paciente es tratada con terapia hormonal y antipsicóticos, consiguiéndose la remisión clínica completa. Resultados: La aparición de trastornos mentales, especialmente trastornos del estado de ánimo, durante las enfermedades de la tiroides se conoce desde hace un siglo, mientras que los trastornos psicóticos asociados con disfunción tiroidea rara vez se describen. Conclusiones: Este caso pone de relevancia el papel del equilibrio hormonal de la tiroides en el inicio de las manifestaciones psicóticas y enfatiza la necesidad de valorar la funcionalidad de esta glándula endocrina en el contexto del diagnóstico etiológico de la psicosis

Objective: The aim of this article is to analyse, using a clinical case, the psychotic disorders related to hypothyroidism. Case report: The case is presented of a 51-year-old woman who was admitted to the hospital with an acute psychotic disorder, as well as paranoid delusions and hallucinatory behaviour. The evaluation revealed a severe hypothyroid state, for which the patient was treated with hormone therapy and antipsychotics, resulting in full clinical remission. Results: The occurrence of mental disorders, especially mood disorders, during thyroid diseases have been known for a century, while psychotic disorders associated with thyroid diseases are rarely described. Conclusions: This case highlights the role of thyroid hormone balance in the onset of psychotic manifestations, and emphasises the need to assess the functionality of this endocrine gland in the context of the aetiological diagnosis of psychosis