Franssen Anouchka, Sienaert Pascal
Universitair Psychiatrisch Centrum KU Leuven, Kortenberg, Belgium.
Academic Center for ECT and Neuromodulation (AcCENT), Universitair Psychiatrisch Centrum KU Leuven, Kortenberg, Belgium.
BMJ Case Rep. 2019 Mar 4;12(3):e224017. doi: 10.1136/bcr-2017-224017.
The objective of this article is to describe the possible association of catatonia and temporal brain lesions. This is a case presentation of a 57-year-old man presenting with depression, with catatonia secondary to a temporal glioblastoma. He was referred to hospital because for a sudden deterioration in depressed state. He was diagnosed with catatonia and treated successfully with lorazepam. During his admission, he became increasingly disinhibited, and an MRI scan revealed an intracranial mass in the right temporal lobe, with uncal herniation and a mass effect. Surgical resection of the entire tumour was successful. Histological examination revealed a glioblastoma multiforme requiring additional chemoradiotherapy. Postoperatively, catatonic signs and symptoms were not detectable. A postsurgical frontal syndrome with disinhibition and logorrhoea was present and gradually normalised over the course of several weeks. Catatonia can be the presenting symptom of a temporal brain tumour, and should therefore prompt the physician to a thorough medical investigation.
本文的目的是描述紧张症与颞叶脑病变之间可能存在的关联。这是一例57岁男性患者的病例报告,该患者表现为抑郁,继发于颞叶胶质母细胞瘤的紧张症。他因抑郁状态突然恶化而被转诊至医院。他被诊断为紧张症,并使用劳拉西泮成功治疗。在他住院期间,他的抑制解除症状越来越明显,磁共振成像扫描显示右侧颞叶有一个颅内肿块,伴有钩回疝和占位效应。整个肿瘤的手术切除成功。组织学检查显示为多形性胶质母细胞瘤,需要额外的放化疗。术后,未检测到紧张症的体征和症状。出现了术后额叶综合征,表现为抑制解除和多语症,并在数周内逐渐恢复正常。紧张症可能是颞叶脑肿瘤的首发症状,因此应促使医生进行全面的医学检查。