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Psychiatric comorbidity in a patient with opsoclonus-myoclonus syndrome. differences in the transition from childhood to adulthood: A case report

Published online by Cambridge University Press:  13 August 2021

F. Casanovas*
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
L. Martínez
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
R. Cirici
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
F. Dinamarca
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
D. García
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
A. Pérez
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
L. Diaz
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
M.T. Nascimento
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
J.I. Castro
Affiliation:
Institut De Neuropsiquiatria I Addiccions (inad), Hospital del Mar, Barcelona, Spain
*
*Corresponding author.

Abstract

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Introduction

Opsoclonus-Myoclonus syndrome (OMS), also known as Kinsbourne syndrome, is a paraneoplasic pediatric condition characterized by erratic eye movements and generalized myoclonus. Previous studies have described a wide range of psychiatric comorbidities in children with this syndrome. Cognitive impairment (especially intellectual capacity and language), affective symptoms (irritability, poor mood regulation) and behavioral problems are the most frequent presentations (1). However, there is a lack of literature describing the progression of this symptoms when the patient reaches the adulthood.

Objectives

To illustrate the psychiatric comorbidity of an adult patient with Opsoclonus-Myoclonus syndrome.

Methods

We present one case-report and literature research of the topic.

Results

We present a 18 year old girl diagnosed with OMS and Graves-Basedow hyperthyroidism. During her childhood she started presenting attention and comprehension difficulties. She was diagnosed with an Attention Deficit Hyperactivity Disorder (ADHD) and started treatment with methylphenidate. She completed elementary and secondary education. During the adulthood, the main psychiatric comorbidity was related to affective symptoms. We observed an impaired mood regulation, hypothymia, anhedonia, and frequent episodes of irritability, which persisted after the thyroid regulation. This caused incremented anxious symptoms and insomnia that were treated with mirtazapine and lormetazepam. After some weeks, she fulfilled criteria of a depressive episode and we started antidepressant treatment with vortioxetine.

Conclusions

- Adult patients diagnosed with OMS during childhood can persist presenting ADHD as a comorbidity. - Affective symptoms, and even a major depressive episode, should be considered during the follow-up of this population. Insight of the cognitive limitations could be a risk factor for a depression.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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