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Manic episode secondary to single right cerebellar metastasis in context of ovarian tumor: report of clinical case

Published online by Cambridge University Press:  01 September 2022

A. Téllez Gómez  and
M.T. Rubio Granero
A. Téllez Gómez*
Affiliation:
Hospital Universitario y Politécnico La Fe, Department Of Psychiatry And Psychology, Valencia, Spain
M.T. Rubio Granero
Affiliation:
Hospital Universitario y Politécnico La Fe, Department Of Psychiatry And Psychology, Valencia, Spain
*
*Corresponding author.

Abstract

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Introduction

The cerebellum is often overlooked when evaluating neuropsychiatric disorders. Lately, evidence has increased for the existence of cerebellar connections -generally in relation to vermis and posterior lobe- with cortical areas related to pathophysiology of psychiatric disorders. The cerebellar affective cognitive syndrome, also known as Schmahmann syndrome, has even been described with an evaluation scale.

Objectives

Case report of a patient suffering a manic episode in context of single right cerebellar metastasis derived from ovarian tumor.

Methods

A non-systematic literature review was conducted on PubMed database on cerebellum pathology related to psychiatrics disorders. The clinical case report was prepared through the review of the patient´s clinical record.

Results

The authors introduce the case of a 50-year-old woman, diagnosed with high-grade serous ovarian tumor, with single right cerebellar metastasis of 42mm, who was admitted to oncology due to behavioral alteration, with no prior psychiatric history. The patient showed hyperthymic mood, with speech scanned but fluid, manifesting intense well-being and ideation of mystical-religious and megalomaniac content. Haloperidol up to 7.5mg/8 hours and clonazepam 2 mg/8 hours were prescribed, switching haloperidol to olanzapine up to 25mg/day after several days, since the symptoms did not improve. Valproic acid 500 mg/24 hours was also added. Progressive improvement was seen, without worsening of motor symptoms or instability. The CCAS scale (Cerebellar Cognitive Affective/Schmahmann syndrome) was performed, with a positive result (10/10) being> 3 definitive CCAS.

Conclusions

The relationship between cerebellum and neuropsychiatric disorders is still partly unknown, requiring more research to be able to carry out specific diagnoses and treatments for patients.

Disclosure

No significant relationships.

Keywords

cognitive affective cerebellar syndromemetastasismaniacerebellum
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S216
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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