Weiss C, Santander J, Torres R
Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Apoquindo 3990, Oficina 502, Las Condes, 755-0112 Santiago, Chile.
Case Rep Psychiatry. 2013;2013:452646. doi: 10.1155/2013/452646. Epub 2013 Sep 4.
The following case study describes a 22-year-old woman with depression and symptoms of psychosis who developed neuroleptic malignant syndrome after using Risperidone, thus requiring life support equipment and Bromocriptine, later recovering after seven days. From a psychiatric and neurological point of view, however, the persistence of catatonic syndrome and Cotard syndrome delusions was observed, based on assertions such as "I do not have a heart," "my heart is not beating," "I can not breathe," "I am breaking apart," "I have no head" (ideas of negation) and statements about the patient being responsible for the "death of the whole world" (ideas of enormity). Brain NMR revealed leukoencephalopathy, interpreted as scar lesions caused by perinatal neurological damage, after discarding other pathologies. The patient responded well to electroconvulsive therapy after 11 sessions. Organic vulnerability to these syndromes, as well as their coexistence and clinical differentiation is discussed in the light of the data observed.
以下病例研究描述了一名22岁患有抑郁症和精神病症状的女性，她在使用利培酮后出现了神经阻滞剂恶性综合征，因此需要生命支持设备和溴隐亭，七天后康复。然而，从精神病学和神经学角度来看，观察到紧张症综合征和科塔尔综合征妄想持续存在，依据诸如“我没有心脏”、“我的心脏不跳动”、“我无法呼吸”、“我正在分裂”、“我没有头”（否定观念）以及关于患者对“整个世界的死亡”负责的表述（夸大观念）等断言。脑部核磁共振显示为白质脑病，在排除其他病变后，被解释为围产期神经损伤导致的瘢痕性病变。患者在接受11次电休克治疗后反应良好。根据观察到的数据，讨论了对这些综合征的器质性易感性，以及它们的共存和临床鉴别。
