A possible explanation for resistance in schizophrenia
Introduction Arachnoid cyst is a neurological tumor. It’s rare and benign. Its association to psychosis has been described in literature. Objectives Through a case report and a review of the literature we hypothesize that arachnoid cyst is the cause of resistance in a patient with schizoaffective...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822011774/type/journal_article |
| _version_ | 1797616200823341056 |
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| author | B. Emna A. Larnaout K. Souabni R. Lansari W. Melki |
| author_facet | B. Emna A. Larnaout K. Souabni R. Lansari W. Melki |
| author_sort | B. Emna |
| collection | DOAJ |
| description |
Introduction
Arachnoid cyst is a neurological tumor. It’s rare and benign. Its association to psychosis has been described in literature.
Objectives
Through a case report and a review of the literature we hypothesize that arachnoid cyst is the cause of resistance in a patient with schizoaffective disorder.
Methods
Starting from a case report, we conducted a literature review on “PubMed”, using key words “arachnoid cyst”, “arachnoid cyst a psychiatry”, “arachnoid cyst and schizoaffective disorder”, “arachnoid cyst and schizophrenia”
Results
Mr. AA is 50 years old, has diabetes treated with metformin, hypercholesterolemia and celiac disease under gluten free diet. He has been diagnosed with schizoaffective disorder in 1992, initially put on haloperidol and carbamazepine. Since the patient wasn’t getting better, we suspected no-compliance so we switched haloperidol for fluphenazine decanoate. The patient still suffered from persecutory delusion and auditory hallucinations. We started him on clozapine still with no improvement. So, we concluded to the resistance of schizoaffective disorder considered electroconvulsive therapy (ECT). A cerebral MRI was conducted, prior to ECT, objectifying a left anterior frontal arachnoid cyst of 26 millimeters from the main axis producing a mass effect on the cerebral cortex. This neurological tumor didn’t require neurosurgery.
Conclusions
Our patient was resistant to all treatments including clozapine. The only anomaly discovered was the arachnoid cyst. Could this explain the resistance of this patient and others like him? Could this be an interesting research path to further elucidate the mystery of metal disorder?
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:38:01Z |
| format | Article |
| id | doaj.art-59a4f4d7aad44e12a6df5902004b71b4 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:38:01Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-59a4f4d7aad44e12a6df5902004b71b42023-11-17T05:09:08ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S463S46410.1192/j.eurpsy.2022.1177A possible explanation for resistance in schizophreniaB. Emna0A. Larnaout1K. Souabni2R. Lansari3W. Melki4military hospital of Tunis, Psychiatric Departement, Denden, TunisiaRazi Hospital, Psychiatry D, Manouba, TunisiaRazi Hospital, Psychiatry D, Manouba, TunisiaRazi Hospital, Psychiatry D, Manouba, TunisiaRazi Hospital, Psychiatry D, Manouba, Tunisia Introduction Arachnoid cyst is a neurological tumor. It’s rare and benign. Its association to psychosis has been described in literature. Objectives Through a case report and a review of the literature we hypothesize that arachnoid cyst is the cause of resistance in a patient with schizoaffective disorder. Methods Starting from a case report, we conducted a literature review on “PubMed”, using key words “arachnoid cyst”, “arachnoid cyst a psychiatry”, “arachnoid cyst and schizoaffective disorder”, “arachnoid cyst and schizophrenia” Results Mr. AA is 50 years old, has diabetes treated with metformin, hypercholesterolemia and celiac disease under gluten free diet. He has been diagnosed with schizoaffective disorder in 1992, initially put on haloperidol and carbamazepine. Since the patient wasn’t getting better, we suspected no-compliance so we switched haloperidol for fluphenazine decanoate. The patient still suffered from persecutory delusion and auditory hallucinations. We started him on clozapine still with no improvement. So, we concluded to the resistance of schizoaffective disorder considered electroconvulsive therapy (ECT). A cerebral MRI was conducted, prior to ECT, objectifying a left anterior frontal arachnoid cyst of 26 millimeters from the main axis producing a mass effect on the cerebral cortex. This neurological tumor didn’t require neurosurgery. Conclusions Our patient was resistant to all treatments including clozapine. The only anomaly discovered was the arachnoid cyst. Could this explain the resistance of this patient and others like him? Could this be an interesting research path to further elucidate the mystery of metal disorder? Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822011774/type/journal_articlearachnoid cystresistant schizoaffective disordercomorbidity with schizophrenia |
| spellingShingle | B. Emna A. Larnaout K. Souabni R. Lansari W. Melki A possible explanation for resistance in schizophrenia European Psychiatry arachnoid cyst resistant schizoaffective disorder comorbidity with schizophrenia |
| title | A possible explanation for resistance in schizophrenia |
| title_full | A possible explanation for resistance in schizophrenia |
| title_fullStr | A possible explanation for resistance in schizophrenia |
| title_full_unstemmed | A possible explanation for resistance in schizophrenia |
| title_short | A possible explanation for resistance in schizophrenia |
| title_sort | possible explanation for resistance in schizophrenia |
| topic | arachnoid cyst resistant schizoaffective disorder comorbidity with schizophrenia |
| url | https://www.cambridge.org/core/product/identifier/S0924933822011774/type/journal_article |
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