Caliyurt Okan, Vardar Erdal, Tuglu Cengiz
Psychiatry Department, School of Medicine, Trakya University, Edirne, Turkey.
J Psychiatry Neurosci. 2004 Mar;29(2):138-41.
We report a case of Cotard's syndrome associated with psychotic symptoms. A 27-year-old man was admitted to hospital with the diagnosis of schizophreniform disorder. His presenting symptoms, which had started 1 month before hospital admission, were somatic delusions of gastrointestinal and cardiovascular malfunction and the absence of a stomach, which resulted in a decrease in weight from 75 kg to 63 kg in 1 month. Cranial computed tomographic images showed dilatation of the lateral and third ventricles, whereas magnetic resonance imaging revealed central atrophy and lateral ventricle dilatation. Single- photon emission computed tomography demonstrated left temporal, left frontal and left parietal hypoperfusion. The patient did not respond to antipsychotic therapies, but he was successfully treated with electroconvulsive therapy. This report emphasizes that Cotard's syndrome may be accompanied by lesions of the left hemisphere and that electroconvulsive therapy could be the first-line therapy in such patients with psychotic disorder.
我们报告一例伴有精神病性症状的科塔尔综合征。一名27岁男性因精神分裂症样障碍入院。他在入院前1个月开始出现的症状为胃肠道和心血管功能障碍的躯体妄想以及胃缺失，这导致其体重在1个月内从75千克降至63千克。头颅计算机断层扫描图像显示侧脑室和第三脑室扩张，而磁共振成像显示中央萎缩和侧脑室扩张。单光子发射计算机断层扫描显示左侧颞叶、左侧额叶和左侧顶叶灌注不足。该患者对抗精神病药物治疗无反应，但接受电休克治疗后获得成功。本报告强调，科塔尔综合征可能伴有左半球病变，电休克治疗可能是此类伴有精神病性障碍患者的一线治疗方法。
