Centre for Mental Health, Unit for Adolescent Psychiatry, University Psychiatric Hospital Ljubljana, Grablovičeva 44a, 1000, Ljubljana, Slovenia.
Unit for Special Laboratory Diagnostics, University Medical Centre Ljubljana, University Children's Hospital, Vrazov trg 2, 1000, Ljubljana, Slovenia.
BMC Psychiatry. 2019 Feb 11;19(1):67. doi: 10.1186/s12888-019-2047-1.
Primary brain calcification (PBC), a neurodegenerative disorder with characteristic calcium deposits in the basal ganglia and other brain areas, typically presents with various neurological and psychiatric symptoms in the fourth or fifth decade of life or later. We present the case of a patient with psychiatric manifestations much earlier than usual, in the second decade of life.
The case of an adolescent female with acute psychotic symptoms, emotional instability, disorganized and suicidal behavior, stereotypical movements, below average intelligence and a three-year history of headaches is reported. Among others, the presentation included tactile hallucinations with secondary hypochondriacal delusions, which are rarely described in this diagnosis. Massive calcinations in the area of the basal ganglia and thalamus were determined by computerized tomography. Other causes of brain calcification were excluded. No causative mutations were found in selected genes. All the symptoms apart from lower intellectual abilities improved with quetiapine and sertraline. The patient showed no side effects.
This case report highlights the successful use of quetiapine for symptomatic treatment of acute psychosis due to PBC in an adolescent without exacerbating extrapyramidal symptoms.
原发性脑钙化（PBC）是一种神经退行性疾病，特征是基底节和其他脑区有钙沉积，通常在第四或第五个十年或更晚出现各种神经和精神症状。我们报告了一例发病年龄远早于通常情况的患者，在二十岁出头时就出现了精神症状。
患者为一名青春期女性，表现为急性精神病性症状、情绪不稳定、行为紊乱和自杀倾向、刻板运动、智力低于平均水平以及头痛病史三年。其表现包括触觉幻觉伴继发疑病症妄想，在该诊断中很少描述。计算机断层扫描显示基底节和丘脑有大量钙化。排除了其他引起脑钙化的原因。在选定的基因中未发现致病突变。除了智力低下外，所有症状均在使用喹硫平和舍曲林后得到改善。患者没有出现副作用。
本病例报告强调了在青少年中使用喹硫平治疗 PBC 引起的急性精神病的有效性，且不会加重锥体外系症状。
