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Thalamo-frontal Psychosis

Published online by Cambridge University Press:  02 January 2018

Iain McGilchrist ,
Laura H. Goldstein ,
Danitza Jadresic  and
Peter Fenwick
Iain McGilchrist
Affiliation:
Neuropsychiatry and Epilepsy Unit, Maudsley Hospital, Denmark Hill, London SE5 8AZ
Laura H. Goldstein
Affiliation:
Neuropsychiatry and Epilepsy Unit, Maudsley Hospital, Denmark Hill, London SE5 8AZ
Danitza Jadresic*
Affiliation:
Neuropsychiatry and Epilepsy Unit, Maudsley Hospital, Denmark Hill, London SE5 8AZ
Peter Fenwick
Affiliation:
Neuropsychiatry and Epilepsy Unit, Maudsley Hospital, Denmark Hill, London SE5 8AZ
*
∗University Department of Psychiatry, Manchester Royal Infirmary, Oxford Road, Manchester M13 9PL
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Abstract

A 43-year-old man presented with an 18-month history of acute-onset cyclical behavioural change affecting mood, appetite, sleep, and energy levels. This had followed an initial episode of transient drowsiness which lasted 24 hours. On examination, there was soma evidence of visual memory and frontal lobe deficits. A brain CT scan showed bilateral thalamic infarcts and a brain SPECT scan showed bilateral hypoperfusion of the frontal lobes. To our knowledge, this is the first reported case of thalamic infarction associated with acute-onset cyclical affective psychosis with clinical and neurophysiological features of frontal lobe syndrome. The case also highlights the possible role of thalamofrontal circuits in the pathogenesis of the Kleine-Levin syndrome.

British Journal of Psychiatry (1993), 163, 113–115

Type
Brief Reports
Information
The British Journal of Psychiatry , Volume 163 , Issue 1 , July 1993 , pp. 113 - 115
Copyright
Copyright © The Royal College of Psychiatrists 

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