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Focal neurocognitive dysfunctions in abstinence delirium: a case report

Published online by Cambridge University Press:  18 September 2015

P. Mariën ,
F. Borggreve ,
W. Spanoghe ,
J. Saerens ,
B.A. Pickut  and
P.P. De Deyn
P. Mariën*
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
F. Borggreve
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
W. Spanoghe
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
J. Saerens
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
B.A. Pickut
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
P.P. De Deyn
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen Departement Neurologie, Born-Bunge Instituut, Laboratorium Neurochemie en Gedrag, Universiteit Antwerpen
*
A.Z. Middelheim, Dienst Neurologie, Lindendreef 1, B-2020 Antwerpen, België
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Summary

Due to abrupt interruption of hidden benzodiazepine-use, a 68-year-old woman developed a full-blown abstinence delirium characterized by epileptic seizures and progressive focal neurocognitive symptoms. The evolution of such rare neuro-linguistic phenomena as an echoism, palilalia and glossomania associated with a progressive visuo-perceptive syndrome and a visual hallucinosis are for the first time reported within the context of withdrawal. Notwithstanding the lack of any neuroradiological evidence for a morphological lesion in the clinically expected brain regions, the anatomo-clinical hypothesis of a focal frontal and parieto-occipital dysfunction was explicitly corroborated by repeated 99mTc-HMPAO SPECT findings.

Keywords

Benzodiazepinesabstinence deliriumneuropsychologyfocal dysfunctionsvisual hallucinosispalilaliaglossomania99mTc-HMPAO SPECTBenzodiazepinenabstinentiedeliriumneuropsychologic focale dysfunctiesvisuele hallucinosepalilalieglossomanie99mTc-HMPAO SPECT
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 9 , Issue 3 , September 1997 , pp. 107 - 115
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1997

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References

Literatuur

1.Owen, RT, Tyrer, P. Benzodiazepine dependence, a review of the evidence. Review articles. Drugs 1983; 25: 385–98.CrossRefGoogle Scholar
2.Koponen, H, Stenback, U, Mattila, E, et al.Delirium among elderly persons admitted to a psychiatric hospital: clinical course during the acute state and one-year follow-up. Acta psychiat scand 1989; 79: 579–85.CrossRefGoogle ScholarPubMed
3.Rockwood, K. Acute confusion in elderly medical patients. J Am geriatr Soc 1989; 37: 150–4.CrossRefGoogle ScholarPubMed
4.Johnson, JC, Gottlieb, GL, Sullivan, E, et al.Using DSM-III criteria to diagnose delirium in elderly general medical patients. J Gerontol 1990; 45: 113–9.CrossRefGoogle ScholarPubMed
5.Levkoff, SE, Evans, DA, Liptzin, B, et al.Delirium: the occurrence and persistence of symptoms among elderly hospitalized patients. Arch intern Med 1992; 152: 334–40CrossRefGoogle ScholarPubMed
6.Dessonville Hill, C, Risby, E, Morgan, N. Cognitive deficits in delirium: assessment over time. Psychopharmacol Bull 1992; 28: 401–7.Google Scholar
7.Chedru, F, Geschwind, N. Disorders of higher cortical functions in acute confusional states. Cortex 1972; 8: 395–411.CrossRefGoogle ScholarPubMed
8.Folstein, M, Folstein, S, McHugh, P. ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J psychiat Res 1987; 12: 189–198.CrossRefGoogle Scholar
9.Cole, MG, Dastoor, D. A new hierarchic approach to the measurement of dementia. Psychosomatics 1987; 28: 298–305.CrossRefGoogle Scholar
10.Rosen, WG, Mohs, RC, Davis, KL. A new rating scale for Alzheimer's disease. Am J Psychiat 1984; 141: 1356–64.Google ScholarPubMed
11.Stinissen, J, Willems, PJ, Coetsier, P, et al.Handleiding bij de Nederlandstalige bewerking van de Wechsler Adult Intelligence Scale (W.A.I.S.). Lisse: Swets & Zeitlinger, 1970.Google Scholar
12.Wechsler, D. Manual for the Wechsler Memory Scale-Revised. New York: Psychol Corp, 1987.Google Scholar
13.Goodglass, H, Kaplan, E. The Assessment of Aphasia and related Disorders. 2nd ed. Philadelphia: Lea & Febiger, 1983.Google Scholar
14.Kaplan, E, Goodglass, H, Weintraub, S. Boston Naming Test. Philadelphia: Lea & Febiger, 1983.Google Scholar
15.Huber, W, Poeck, K, Weniger, D, Willems, K. Der Aachener Aphasie Test (AAT). Göttingen: Hogrefe, 1983.Google Scholar
16.Bouw, M, Draaisma, Y, van der Linden, S, in't Veld M. FAST: Frenchay Afasie Screeningstest. Log Fon 1994; 4: 114–8.Google Scholar
17.De Renzi, E, Vignolo, LA. The token test: a sensitive test to detect receptive disturbances in aphasia. Brain 1962; 85:665–78.CrossRefGoogle Scholar
18.Schmand, B, Lindeboom, J, van Harskamp, F.Nederlandse Lees-test voor Volwassenen. Lisse: Swets & Zeitlinger, 1992.Google Scholar
19.Benton, AL, Hamsher, K deS, Varney, NR, Spreen, O. Contributions to neuro-psychological assessment: a clinical manual. New York: Oxf Univ Press, 1983.Google Scholar
20.Raven, JC. Coloured Progressive Matrices. London: HK Lewis, 1976.Google Scholar
21.Van Steenkiste, M, De Roeck, J. Afhankelijkheid en abstinentie-verschijnselen bij gebruik van benzodiazepinen. Ned Tijdschr Geneeskd 1986; 130: 1224–7.Google Scholar
22.DeRenzi, E. Sulla catafasia. Giorn Ital Sci Med 1879; 1: 474–9.Google Scholar
23.Souques, MA. Palilalie. Rev Neurol 1908; 16: 340–2.Google Scholar
24.Dupré, E, Savoureaux, L. Palilalie chez une pseudobulbaire. Rev Neurol 1914; 27: 453–6.Google Scholar
25.Frey, E. Beiträge zur Klinik und pathologischen Anatomie der Alzheimerischen Krankheit. Zeitschr gesamte Neurol Psychiat 1914; 27: 397–434.Google Scholar
26.Pick, A. Die Palilalie, ein Teilstück striäter Motilitätsstörungen. Abb Neurol Psychiat Psychol Grenzgeb 1921; 13: 178–224.Google Scholar
27.Marie, P, Levy, G. Un singulier trouble de la parole: la palilalie. Monde méd 1925; 35: 329–44.Google Scholar
28.Sterling, W. Palilalie et le symptome ‘linguosalivaire’ dans le parkinsonisme encéphalitique. Rev Neurol 1924; 205–20.Google Scholar
29.Critchley, M. On palilalia. J Neurol Psychopathol 1927; 8: 23–32.CrossRefGoogle ScholarPubMed
30.Brain, R. Speech Disorders. Aphasia, Apraxia and Agnosia. London: Butterworth, 1961.Google Scholar
31.Boller, F, Boller, M, Denes, F, et al.Familial palilalia. Neurology 1973; 23: 1117–25.CrossRefGoogle ScholarPubMed
32.Alajouanine, T, Castaigne, P, Sabouraud, O, et al.Palilalie paroxystique et vocalisations itératives au cours de crises épileptiques par lésion intéressant l'aire motrice supplementaire. Rev Neurol 1959; 101: 685–97.Google Scholar
33.Benson, DF. Clinical Neurology and Neurosurgery Monographs: Aphasia, Alexia, and Agraphia. New York: Churchill Livingstone, 1979.Google Scholar
34.Hasegawa, O, Kobayashi, H, Yoshii, Y, et al.A case of palilalia with paramedian thalamic and midbrain infarcts. Neurol Med (Tokyo) 1986; 24: 573–8. (in Japanese)Google Scholar
35.Yasuda, Y, Akiguchi, I, Ino, M, et al.Paramedian thalamic and midbrain infarcts associated with palilalia. J Neurol Neurosurg Psychiat 1990; 53: 797–9.CrossRefGoogle ScholarPubMed
36.Nagura, N, Sugishita, M, Yamanouchi, H, Tohgi, H. Palilalia and aphasia associated with occlusion of internal carotid artery. Neurol Med (Tokyo) 1982; 16: 554–8. (in Japanese)Google Scholar
37.Sato, M, Goto, T, Watanabe, K. Transcortical sensory aphasia and palilalia following left frontal lesion. Jap J Neuropsychol (Tokyo) 1991; 7: 202–8. (in Japanese)Google Scholar
38.Maeshima, S, Itakura, T, Nakai, K, et al.Palilalia and unilateral spatial neglect caused by a right frontal lesion: case study. Aphasiol 1996; 1: 97–106.CrossRefGoogle Scholar
39.Helm, NA. Management of palilalia with a pacing board. J Speech Hear Disord 1979; 44: 350–3.CrossRefGoogle ScholarPubMed
40.Lecours, AR, De Kock, J. Sprachlich neugebildete Segmente und Glossolalie. Rev appl Linguistics 1977; 37: 3.Google Scholar
41.Lecours, AR, Vanier-Clément, M. Schizophasia and jargonaphasia. A comparative description with comments on Chaika's and Fromkin's receptieve looks at schizophrenic language. Brain Lang 1976; 3: 516.CrossRefGoogle Scholar
42.Hughlings-Jackson, J. Notes on cases of epileptic seizures: intellectual warnings of epileptic seizures. In: Taylor, J, ed. Selected Writings of John Hughlings Jackson. London: Hodder and Stoughton, 1931: 295–307.Google Scholar
43.Hoksbergen, I, Pickut, BA, Mariën, P, et al.SPECT findings in an unusual case of visual hallucinosis. J Neurol 1996; 243: 594–8.CrossRefGoogle Scholar
44.Ludwig, BI, Ajmone Marsan, C. Clinical ictal patterns in epileptic patients with occipital electroencephalographic foci. Neurology 1975; 25: 463–71.CrossRefGoogle ScholarPubMed
45.Gregor, JC, Zili, CA, Gotlib, IH. Acute psychosis associated with oral trimethoprim- sulfamethoxazole therapy. Can J Psychiat 1993; 38: 56–8.CrossRefGoogle ScholarPubMed