1/14. Progressive myoclonic epilepsies syndrome (Ramsay Hunt syndrome) with mental disorder: report of two cases.Ramsay Hunt syndrome (RHS) is a rare condition within the progressive myoclonic epilepsies syndrome (PME), with a triad of action myoclonus, grand mal seizure and severe cerebellar ataxia. There are few reports about the psychiatric disturbances associated with PME or RHS. The present study examines the evidence that RHS may accompany an organic mental syndrome, ethanol's effective suppression of myoclonus, and the possible resultant problem of alcohol dependence in RHS patients. Two brothers with the previous long-standing diagnosis of RHS and their mental symptoms of persecutory delusion and depression are reported, as well as the additional problem of alcohol dependence in one of them. The cerebellar dysfunction found in RHS may be associated with an underlying organic condition. Determination of the relationship between cerebellar dysfunction and psychosis in RHS will require further study. Although the mechanism of the suppression of myoclonus by alcohol remains unclear, patients should be allowed to drink socially, and alcohol consumption should not be totally prohibited. However, effective treatment of the problems of alcohol tolerance, abuse, or dependence requires the cooperation of both neurologists and psychiatrists.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
2/14. An "accidental" acute psychosis with ecstasy use.Over the last 10 years, europe has witnessed the development of the ecstasy phenomenon; this term is used to describe several products sharing more or less the same effects. The most widely used and hence the most well known is 3,4 MDMA, but MDA, MDEA, MBDB and even 2CB or nexus are available. The psychopathological consequences of MDMA use in man are relatively poorly understood. The case reported here involves an acute psychotic episode with residual symptoms after six months, with a sudden onset at least 12 hours after taking alcohol and ecstasy without realising it, in an individual with no previous psychopathology other than a moderate anxiety disorder. Twelve cases of acute psychotic episodes after taking ecstasy have been reported in the literature; two after taking the drug on two occasions and one after a single use. No authors have examined the previous mental state or possible previous psychopathology with any precision. The present subject had not displayed any previous psychotic behavior when tested with a proven standardized interview technique; this was confirmed by his peers and his family. He did, however, show signs of social phobia. Although the personality of an individual is a factor in taking a drug, and probably in the quality of the psychotropic effects experienced, a host of arguments favor the appearance of psychotic symptoms de novo, which were probably related to direct toxicity by MDMA and/or its metabolites on the serotoninergic neurons.- - - - - - - - - - ranking = 4keywords = psychosis (Clic here for more details about this article) |
3/14. Psychosis and pregnancy: five cases of severely ill women.An increasing number of patients with chronic mental disease are now integrated in society. As a consequence, women with severe psychiatric illness may become pregnant and wish to complete the pregnancy and to give birth to a child. The lack of sensation of reality in these patients and their social situation may result in particular problems in their treatment, and it may be necessary to admit them to a psychiatric ward before delivery. In this paper five cases of pregnant women with severe and chronic psychosis are described. These patients had many problems in common. Thus, they were all schizophrenics with very severe psychopathology, had poor understanding of their own situation, and lacked social networks. All the fathers were non-Danish. coercion was used in all cases. To help women with severe mental illness to go through pregnancy and childbirth requires close collaboration between psychiatric and obstetric staff and social workers, and this should be organized in an institution with experience in the treatment of this type of patient.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
4/14. disulfiram-induced encephalopathy.Two patients with disulfiram-(Antabuse-)induced encephalopathy exhibited paranoid ideas, disorientation, impaired memory, ataxia, dysarthria, snout and grasp reflexes, and abnormal electroencephalograms. The first patient developed symptoms on two occasions, each time after disulfiram administration. The second patient experienced a generalized seizure followed by fulminant psychosis three weeks after starting disulfiram therapy. Spinal fluid examination in the latter patient revealed a low homovanillic acid (HVA) level. Since disulfiram inhibits dopamine oxidation, disulfiram-induced encephalopathy may be related to excess dopaminergic activity in the central nervous system.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
5/14. Tuberculous meningitis masked by delirium in an alcohol-dependent patient: a case report.OBJECTIVE: patients with alcohol dependence syndrome can present with delirium which will mask underlying organic causes for the delirium. However, other medical diseases can also present with similar symptoms and should not be missed. The issues related to differentiating the different causes of delirium are briefly discussed. We describe a case of tuberculous meningitis in a patient with history of alcohol dependence who presented with delirium. METHOD: A case report. RESULTS: A 38-year-old male was admitted with history of irrelevant talk and abnormal behaviour of 2-month duration. He was also disoriented and his short-term memory was impaired. He reported visual hallucinations. He had history of alcohol dependence of 5 years. A detailed mental status examination and neurological workup revealed an organic psychosis. CT scan showed a hypodense lesion suggestive of a tuberculoma. The cerebrospinal fluid findings were corroborative. He responded to antituberculous drugs which he took for one and a half years and recovered completely. He also underwent group therapy for his alcohol dependence and has since then refrained from alcohol intake. Currently he has gone back to his work as a car mechanic. CONCLUSION: We have highlighted the need for diagnosing and investigating carefully the cause of delirium in a patient with alcohol dependence syndrome. This shows that other curable causes of delirium must also be investigated in patients with alcohol dependence.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
6/14. carbamazepine adjunct for nonresponsive psychosis with prior hallucinogenic abuse.Some patients diagnosed as schizophrenic report persistent polymodal hallucinosis following a period of extensive hallucinogenic drug abuse unrelieved by the usual antipsychotic drugs. In this open study, carbamazepine (Tegretol, an anticonvulsant) was administered to three patients with polymodal hallucinosis which had failed to diminish on antipsychotic drugs alone. All three patients showed a marked to complete reduction in symptomatology.- - - - - - - - - - ranking = 4keywords = psychosis (Clic here for more details about this article) |
7/14. A chronic psychotic: a longitudinal perspective.Psychiatric illnesses involve complex interpersonal and biological processes that combine to produce certain clinical signs and symptoms of psychopathology on which psychiatric diagnostics are based. Nevertheless, the clinical presentation of some psychiatric disorders may vary from patient to patient or at different points in time on the same patient. The following case history serves to underscore the importance of the multi-axial approach in combination with longitudinal follow-up when an attempt is made to understand fully complex individuals. In particular, this case involves, at the minimum, the complex interweaving of a psychosis not easily subsumed under either pure schizophrenia or pure affective disorder together with substance abuse. It is the analysis of the serial unfolding of psychopathology that the authors feel will lead to a more comprehensive and better diagnostic formulation of an individual patient.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
8/14. suicide by driving an awl into the brain.In this report, we describe an unusual method of suicide. A 35-year-old man with a history of manic-depressive psychosis and alcohol abuse killed himself by driving an awl into his brain. A theory of the reason for using this bizarre method is discussed, and the well-known question of homicide versus suicide in crime scene investigation is illustrated.- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
9/14. Korsakoff's psychosis due to massive beer intake provoked by diabetes insipidus.Posttraumatic diabetes insipidus, acute pancreatitis, and Wernicke's encephalopathy and Korsakoff's psychosis in a 33-year-old white male alcohol abuser resulted in near-fatal cardiovascular collapse. The Wernicke's encephalopathy and Korsakoff's psychosis resulted from drinking massive quantities of beer to satisfy the thirst induced by diabetes insipidus. Although the diabetes insipidus was controlled with vasopressin, and the need for vasopressin resolved two months after diagnosis, the Wernicke-korsakoff syndrome had not resolved by six months.- - - - - - - - - - ranking = 6keywords = psychosis (Clic here for more details about this article) |
10/14. Parameters of kava used as a challenge to alcohol.The kava bowl, a traditional feature of Pacific Island societies, has been adopted and adapted by a number of Aboriginal (Yolngu) communities of northern australia, where it was introduced in the hope that it would challenge alcohol. This paper reports a study of its usage at Elcho Island, northern territory. At the high level of intake in this community, medical effects hitherto unreported are being observed. Some, such as a condition of detachment, reminiscent of the archetypal 'blissful indolence' of the lotus-eaters of Greek tradition as limned by the poet Homer, are obvious to the lay observer. Other effects are apparently advantageous for the management of alcohol abuse and some forms of psychosis. A surprising effect is the occurrence of a pellagrinous reaction. These observations indicate that further studies of the clinical effects and the human metabolism of high dosage kava are needed. Looming over all are questions of pharmacology. Do the kava pyrones possess anxiolytic or antipsychotic properties? Do they indeed have the property for which Pacific missionaries introduced them to australia, as an alternative to alcoholism?- - - - - - - - - - ranking = 1keywords = psychosis (Clic here for more details about this article) |
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