Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-21T12:09:34.229Z Has data issue: false hasContentIssue false
  • English
  • Français

Focal neurocognitive dysfunctions in abstinence delirium: a case report

Published online by Cambridge University Press:  18 September 2015

P. Mariën ,
F. Borggreve ,
W. Spanoghe ,
J. Saerens ,
B.A. Pickut  and
P.P. De Deyn
P. Mariën*
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
F. Borggreve
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
W. Spanoghe
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
J. Saerens
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
B.A. Pickut
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen
P.P. De Deyn
Affiliation:
Departement Neurologie en Nucleaire Geneeskunde Algemeen Ziekenhuis Middelheim, Antwerpen Departement Neurologie, Born-Bunge Instituut, Laboratorium Neurochemie en Gedrag, Universiteit Antwerpen
*
A.Z. Middelheim, Dienst Neurologie, Lindendreef 1, B-2020 Antwerpen, België
Get access Rights & Permissions [Opens in a new window]

Summary

Due to abrupt interruption of hidden benzodiazepine-use, a 68-year-old woman developed a full-blown abstinence delirium characterized by epileptic seizures and progressive focal neurocognitive symptoms. The evolution of such rare neuro-linguistic phenomena as an echoism, palilalia and glossomania associated with a progressive visuo-perceptive syndrome and a visual hallucinosis are for the first time reported within the context of withdrawal. Notwithstanding the lack of any neuroradiological evidence for a morphological lesion in the clinically expected brain regions, the anatomo-clinical hypothesis of a focal frontal and parieto-occipital dysfunction was explicitly corroborated by repeated 99mTc-HMPAO SPECT findings.

Keywords

Benzodiazepinesabstinence deliriumneuropsychologyfocal dysfunctionsvisual hallucinosispalilaliaglossomania99mTc-HMPAO SPECTBenzodiazepinenabstinentiedeliriumneuropsychologic focale dysfunctiesvisuele hallucinosepalilalieglossomanie99mTc-HMPAO SPECT
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 9 , Issue 3 , September 1997 , pp. 107 - 115
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Literatuur

1.Owen, RT, Tyrer, P. Benzodiazepine dependence, a review of the evidence. Review articles. Drugs 1983; 25: 385–98.CrossRefGoogle Scholar
2.Koponen, H, Stenback, U, Mattila, E, et al.Delirium among elderly persons admitted to a psychiatric hospital: clinical course during the acute state and one-year follow-up. Acta psychiat scand 1989; 79: 579–85.CrossRefGoogle ScholarPubMed
3.Rockwood, K. Acute confusion in elderly medical patients. J Am geriatr Soc 1989; 37: 150–4.CrossRefGoogle ScholarPubMed
4.Johnson, JC, Gottlieb, GL, Sullivan, E, et al.Using DSM-III criteria to diagnose delirium in elderly general medical patients. J Gerontol 1990; 45: 113–9.CrossRefGoogle ScholarPubMed
5.Levkoff, SE, Evans, DA, Liptzin, B, et al.Delirium: the occurrence and persistence of symptoms among elderly hospitalized patients. Arch intern Med 1992; 152: 334–40CrossRefGoogle ScholarPubMed
6.Dessonville Hill, C, Risby, E, Morgan, N. Cognitive deficits in delirium: assessment over time. Psychopharmacol Bull 1992; 28: 401–7.Google Scholar
7.Chedru, F, Geschwind, N. Disorders of higher cortical functions in acute confusional states. Cortex 1972; 8: 395–411.CrossRefGoogle ScholarPubMed
8.Folstein, M, Folstein, S, McHugh, P. ‘Mini-Mental State’: a practical method for grading the cognitive state of patients for the clinician. J psychiat Res 1987; 12: 189–198.CrossRefGoogle Scholar
9.Cole, MG, Dastoor, D. A new hierarchic approach to the measurement of dementia. Psychosomatics 1987; 28: 298–305.CrossRefGoogle Scholar
10.Rosen, WG, Mohs, RC, Davis, KL. A new rating scale for Alzheimer's disease. Am J Psychiat 1984; 141: 1356–64.Google ScholarPubMed
11.Stinissen, J, Willems, PJ, Coetsier, P, et al.Handleiding bij de Nederlandstalige bewerking van de Wechsler Adult Intelligence Scale (W.A.I.S.). Lisse: Swets & Zeitlinger, 1970.Google Scholar
12.Wechsler, D. Manual for the Wechsler Memory Scale-Revised. New York: Psychol Corp, 1987.Google Scholar
13.Goodglass, H, Kaplan, E. The Assessment of Aphasia and related Disorders. 2nd ed. Philadelphia: Lea & Febiger, 1983.Google Scholar
14.Kaplan, E, Goodglass, H, Weintraub, S. Boston Naming Test. Philadelphia: Lea & Febiger, 1983.Google Scholar
15.Huber, W, Poeck, K, Weniger, D, Willems, K. Der Aachener Aphasie Test (AAT). Göttingen: Hogrefe, 1983.Google Scholar
16.Bouw, M, Draaisma, Y, van der Linden, S, in't Veld M. FAST: Frenchay Afasie Screeningstest. Log Fon 1994; 4: 114–8.Google Scholar
17.De Renzi, E, Vignolo, LA. The token test: a sensitive test to detect receptive disturbances in aphasia. Brain 1962; 85:665–78.CrossRefGoogle Scholar
18.Schmand, B, Lindeboom, J, van Harskamp, F.Nederlandse Lees-test voor Volwassenen. Lisse: Swets & Zeitlinger, 1992.Google Scholar
19.Benton, AL, Hamsher, K deS, Varney, NR, Spreen, O. Contributions to neuro-psychological assessment: a clinical manual. New York: Oxf Univ Press, 1983.Google Scholar
20.Raven, JC. Coloured Progressive Matrices. London: HK Lewis, 1976.Google Scholar
21.Van Steenkiste, M, De Roeck, J. Afhankelijkheid en abstinentie-verschijnselen bij gebruik van benzodiazepinen. Ned Tijdschr Geneeskd 1986; 130: 1224–7.Google Scholar
22.DeRenzi, E. Sulla catafasia. Giorn Ital Sci Med 1879; 1: 474–9.Google Scholar
23.Souques, MA. Palilalie. Rev Neurol 1908; 16: 340–2.Google Scholar
24.Dupré, E, Savoureaux, L. Palilalie chez une pseudobulbaire. Rev Neurol 1914; 27: 453–6.Google Scholar
25.Frey, E. Beiträge zur Klinik und pathologischen Anatomie der Alzheimerischen Krankheit. Zeitschr gesamte Neurol Psychiat 1914; 27: 397–434.Google Scholar
26.Pick, A. Die Palilalie, ein Teilstück striäter Motilitätsstörungen. Abb Neurol Psychiat Psychol Grenzgeb 1921; 13: 178–224.Google Scholar
27.Marie, P, Levy, G. Un singulier trouble de la parole: la palilalie. Monde méd 1925; 35: 329–44.Google Scholar
28.Sterling, W. Palilalie et le symptome ‘linguosalivaire’ dans le parkinsonisme encéphalitique. Rev Neurol 1924; 205–20.Google Scholar
29.Critchley, M. On palilalia. J Neurol Psychopathol 1927; 8: 23–32.CrossRefGoogle ScholarPubMed
30.Brain, R. Speech Disorders. Aphasia, Apraxia and Agnosia. London: Butterworth, 1961.Google Scholar
31.Boller, F, Boller, M, Denes, F, et al.Familial palilalia. Neurology 1973; 23: 1117–25.CrossRefGoogle ScholarPubMed
32.Alajouanine, T, Castaigne, P, Sabouraud, O, et al.Palilalie paroxystique et vocalisations itératives au cours de crises épileptiques par lésion intéressant l'aire motrice supplementaire. Rev Neurol 1959; 101: 685–97.Google Scholar
33.Benson, DF. Clinical Neurology and Neurosurgery Monographs: Aphasia, Alexia, and Agraphia. New York: Churchill Livingstone, 1979.Google Scholar
34.Hasegawa, O, Kobayashi, H, Yoshii, Y, et al.A case of palilalia with paramedian thalamic and midbrain infarcts. Neurol Med (Tokyo) 1986; 24: 573–8. (in Japanese)Google Scholar
35.Yasuda, Y, Akiguchi, I, Ino, M, et al.Paramedian thalamic and midbrain infarcts associated with palilalia. J Neurol Neurosurg Psychiat 1990; 53: 797–9.CrossRefGoogle ScholarPubMed
36.Nagura, N, Sugishita, M, Yamanouchi, H, Tohgi, H. Palilalia and aphasia associated with occlusion of internal carotid artery. Neurol Med (Tokyo) 1982; 16: 554–8. (in Japanese)Google Scholar
37.Sato, M, Goto, T, Watanabe, K. Transcortical sensory aphasia and palilalia following left frontal lesion. Jap J Neuropsychol (Tokyo) 1991; 7: 202–8. (in Japanese)Google Scholar
38.Maeshima, S, Itakura, T, Nakai, K, et al.Palilalia and unilateral spatial neglect caused by a right frontal lesion: case study. Aphasiol 1996; 1: 97–106.CrossRefGoogle Scholar
39.Helm, NA. Management of palilalia with a pacing board. J Speech Hear Disord 1979; 44: 350–3.CrossRefGoogle ScholarPubMed
40.Lecours, AR, De Kock, J. Sprachlich neugebildete Segmente und Glossolalie. Rev appl Linguistics 1977; 37: 3.Google Scholar
41.Lecours, AR, Vanier-Clément, M. Schizophasia and jargonaphasia. A comparative description with comments on Chaika's and Fromkin's receptieve looks at schizophrenic language. Brain Lang 1976; 3: 516.CrossRefGoogle Scholar
42.Hughlings-Jackson, J. Notes on cases of epileptic seizures: intellectual warnings of epileptic seizures. In: Taylor, J, ed. Selected Writings of John Hughlings Jackson. London: Hodder and Stoughton, 1931: 295–307.Google Scholar
43.Hoksbergen, I, Pickut, BA, Mariën, P, et al.SPECT findings in an unusual case of visual hallucinosis. J Neurol 1996; 243: 594–8.CrossRefGoogle Scholar
44.Ludwig, BI, Ajmone Marsan, C. Clinical ictal patterns in epileptic patients with occipital electroencephalographic foci. Neurology 1975; 25: 463–71.CrossRefGoogle ScholarPubMed
45.Gregor, JC, Zili, CA, Gotlib, IH. Acute psychosis associated with oral trimethoprim- sulfamethoxazole therapy. Can J Psychiat 1993; 38: 56–8.CrossRefGoogle ScholarPubMed