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Organic lesions and Psychiatry: “A sample on a pendant”

Published online by Cambridge University Press:  01 September 2022

T. Jiménez Aparicio
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
G. Medina Ojeda*
Affiliation:
Sacyl, Hospital Clínico Universitario Valladolid, Psiquiatría, Valladolid, Spain
C. De Andrés Lobo
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
C. Vallecillo Adame
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
J. Gonçalves Cerejeira
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Clinical Hospital of Valladolid, Psychiatry, Valladolid, Spain
G. Guerra Valera
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
A. Gonzaga Ramírez
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
M. Fernández Lozano
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
B. Rodríguez Rodríguez
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
M.J. Mateos Sexmero
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
N. Navarro Barriga
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
N. De Uribe Viloria
Affiliation:
Hospital Universitario Fundación de Alcorcón, Psychiatry, Madrid, Spain
*
*Corresponding author.

Abstract

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Introduction

Brain lesions may induce psychiatric symptoms in some cases. Imaging tests are important to make a differential diagnosis, and therefore initiate an appropriate treatment.

Objectives

Presentation of a clinical case about a patient with psychiatric symptoms who presented an organic lesion.

Methods

Bibliographic review including the latest articles in Pubmed about psychiatric symptoms induced by organic lesions.

Results

We present a 51-year-old male patient, with adequate previous functionality, who attended psychiatric consultations due to changes in his character, with delusional mystical and megalomaniac ideation, verbiage, hypoprosexia, memory loss and insomnia (diagnosed with Bipolar Disorder type II, hypomanic episode). Eventually, a brain computed tomography scan was performed, in which meningioma was visualized. The patient underwent surgery, and he asked to keep a sample of his tumor to always carry it with him on a pendant. Psychiatric symptoms induced by organic lesions are highly variable, depending on the location and size of the lesion, and they may be the first and/or only symptom of a meningioma (up to 21% according to various studies), so it is important to perform imaging tests in some cases. At this time, the patient is under follow-up, he has remained euthymic and stable, and he refuses to take psychopharmacological medication.

Conclusions

Psychiatric symptoms may be the first and/or only manifestation of an organic lesion in some cases. Neuroimaging tests (CT and MR) may be useful in the differential diagnosis. It is important to carry out an indiviualized treatment based on the patient’s pathology, which may include surgery and/or drugs.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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