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1例接受奥氮平治疗的精神分裂症患者出现额叶切除术后紧张症:病例报告

A patient with schizophrenia presenting with post-lobotomy catatonia treated with olanzapine: a case report.

作者信息

Kumagai Ryo, Kitazawa Maiko, Ishibiki Yoshiro, Narumi Kenji, Ichimiya Yosuke

机构信息

Department of Psychiatry, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.

Department of Psychiatry, Youwa Hospital, Tokyo, Japan.

出版信息

Psychogeriatrics. 2017 May;17(3):202-203. doi: 10.1111/psyg.12208. Epub 2016 Jul 13.

Abstract

A 79-year-old Japanese woman with schizophrenia was hospitalized because of idiopathic duodenal stenosis. Three days after discontinuing ingestion, including the administration of psychotropic drugs, the patient demonstrated incoherent behaviour and strong general muscle tension, and was unable to engage in conversation. Computed tomography indicated bilateral regions of low density in the frontal lobes, subsequent to which she was diagnosed with post-lobotomy catatonia. Administration of olanzapine (10 mg/day) improved the patient's condition within a short period. Previous studies have demonstrated an association between the dysfunction of frontal circuits and catatonia; therefore, the observed catatonic episode might relate to the disconnection of nerve fibres in the prefrontal lobes induced by her lobotomy. Olanzapine was likely effective in treating catatonia because of its reported efficacy in improving frontal lobe function.

摘要

一名79岁的日本精神分裂症女性因特发性十二指肠狭窄住院。在停止摄入包括精神药物在内的所有药物三天后,患者出现行为紊乱和全身肌肉强烈紧张,无法进行对话。计算机断层扫描显示额叶双侧低密度区,随后她被诊断为额叶切除术后紧张症。给予奥氮平(10毫克/天)在短时间内改善了患者的病情。先前的研究表明额叶回路功能障碍与紧张症之间存在关联;因此,观察到的紧张症发作可能与她的额叶切除术引起的前额叶神经纤维断开有关。奥氮平可能对治疗紧张症有效,因为有报道称其在改善额叶功能方面具有疗效。

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