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Psychotic disorder NOS with heterotopia

Published online by Cambridge University Press:  10 April 2007

Saxby Pridmore ,
Gerald McInerney ,
Mariusz Rybak  and
Stuart Archer
Saxby Pridmore*
Affiliation:
PICU, Royal Hobart Hospital, Hobart, Tasmania, Australia Discipline of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia
Gerald McInerney
Affiliation:
Department of Medical Imaging, Royal Hobart Hospital, Hobart, Tasmania, Australia
Mariusz Rybak
Affiliation:
PICU, Royal Hobart Hospital, Hobart, Tasmania, Australia
Stuart Archer
Affiliation:
PICU, Royal Hobart Hospital, Hobart, Tasmania, Australia
*
Correspondence to: Prof Saxby Pridmore, PICU, Royal Hobart Hospital, GPO Box 1061L, Hobart 7001, Tasmania, Australia. Tel: +61 3 6222 8308; Fax: +61 3 6222 7040, E-mail: spridmore@iprimus.com.au
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Abstract

Background: Heterotopia are believed to result from faulty neuronal migration. Formerly considered to be extremely rare, with the availability of MRI reports they have appeared more frequently.

Case details: We describe a 42 year old man with episodic disinhibition (violent and sexual) with disorganized thinking and behaviour, and a 20 year history of a diagnosis of schizophrenia. Soon after admission there were vague paranoid delusions. Initially, the cognitive state was impossible to access, but cognitive deficit was later demonstrated using the Mini Mental State Examination (MMSE). Although there was no clear evid??ence of delirium, the MMSE score subsequently improved, as did the disinhibited behaviour.

Results: CT revealed no abnormality. Brain MRI, however, revealed multiple bilateral subependymal heterotopia (SEH).

Conclusion: It is possible for SEH to be associated with a schizophrenia-like syndrome. CT is not sufficient and MRI is required to exclude SEH.

Keywords

Psychosis NOSheterotopianeurodevelopment
Type
Case Report
Information
Journal of Psychiatric Intensive Care , Volume 2 , Issue 2 , December 2006 , pp. 118 - 121
Copyright
Copyright © NAPICU 2007

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