Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech.
Negro, Paulo J
Jung, Patrick L
Marano, Christopher M
Doddi, Seshagiri R
Nimo, Nana Y A
LeMalefant, Rachel M
Myers, Drew A
Haake, Andrea K
JournalCase Reports in Psychiatry
MetadataShow full item record
AbstractOur patient Mr. A is a mentally and physically disabled gentleman. He was first diagnosed with bipolar disorder as a teenager. He incurred a lumbar spinal injury due to a motor vehicle incident in his 20s which led to weakness, numbness, and frequent infection over both of his lower extremities. He also developed alcohol addiction over the course of his life. Mr. A presented to our facility with complicated neuropsychiatric symptoms. By adopting various clinical strategies, we were able to control his symptoms of agitation, self-harm, mood swings, and stereotyped behavior. However, we were not able to improve his neurocognitive functioning or speech impairment which seemed to become severe and irreversible in a period of a few months. We felt disappointed and perplexed by the mixed treatment responses. To understand Mr. A's clinical presentation, various laboratory tests and imaging studies were performed. Different psychotropic medications were used to manage his symptoms. Gradually, we felt that we were able to understand this case better clinically and etiologically. His bipolar disorder, alcohol addiction, and physical injury had likely all contributed to his neuropsychiatric symptoms, directly or indirectly. It is highly possible that an alcohol-related progressive dementia along with his chronic bipolar disorder played a key role in the progression of his brain neurodegeneration. Also, Wernicke-Korsakoff syndrome could reasonably be considered having developed during his clinical course. Moreover, the fluctuation of the patient's neuropsychiatric symptoms we observed during his hospitalization reflects the increased vulnerability of the human brain under sustained neurodegeneration.
Rights/TermsCopyright © 2022 Xiaolin Deng et al.
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/19031
- [Psychiatric manifestations of lupus erythematosus systemic and Sjogren's syndrome].
- Authors: Ampélas JF, Wattiaux MJ, Van Amerongen AP
- Issue date: 2001 Nov-Dec
- [Frontal dementia or dementia praecox? A case report of a psychotic disorder with a severe decline].
- Authors: Vanderzeypen F, Bier JC, Genevrois C, Mendlewicz J, Lotstra F
- Issue date: 2003 Mar-Apr
- Autism Spectrum Disorder and Mental Health Comorbidity Leading to Prolonged Inpatient Admission.
- Authors: Gupta S, Caskey A, Soares N, Augustyn M
- Issue date: 2018 Jul/Aug
- Neurodevelopmental/neuroradiologic recovery of a child infected with HIV after treatment with combination antiretroviral therapy using the HIV-specific protease inhibitor ritonavir.
- Authors: Tepper VJ, Farley JJ, Rothman MI, Houck DL, Davis KF, Collins-Jones TL, Wachtel RC
- Issue date: 1998 Mar
- [Secondary benefits of cognitive rehabilitation for a chronic ethylic patient: effects on disorder consciousness, motivation, and global therapeutic cooperation].
- Authors: Siccardi L, Vautel-Pons D, dos Santos MT, Camus N, Louchart de la Chapelle S
- Issue date: 2014 Jun