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Schizophrenia likely related to be with cadasil: A case report

Published online by Cambridge University Press:  13 August 2021

D. Göy
Affiliation:
Psychiatry, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
Ö. Şahmelikoğlu Onur*
Affiliation:
Psychiatry, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
U. Yesilkaya
Affiliation:
Psychiatry, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery, İstanbul, Turkey
*
*Corresponding author.

Abstract

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Introduction

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is an inherited disease caused by mutations in the Notch3 gene in chromosome 19.The clinical features are primarily neurological, which include recurrent transient ischaemic attacks, strokes, and migraines.However, psychiatric manifestations such as severe depression, psychosis, changes in behavior and personality have also been reported in CADASIL. Symptoms and disease onset vary widely, with signs typically appearing in the mid-30s.Some individuals may not show signs of the disease until later in life.

Objectives

In this case report, we present a possible case of CADASIL, a 67-year old female patient diagnosed with schizophrenia fifteen years ago to discuss the co-occurrence of these conditions in the light of the literature.

Methods

Hospitalization records of the patient viewed.

Results

Our patient suffered from sleep disturbances, hearing religious voices and in psychiatric examination resistant to treatment psychotic symptoms such as blunted affect, mystic, persecutory delusions, auditory hallucinations were present.Cranial magnetic resonance imaging scan was performed and revealed leukoencephalopathy, high-signal intensity lesions in the periventricular white matter consistent with a diagnosis of CADASIL.Atypical antipsychotics found to be effective in treating psychotic symptoms in our case.

Conclusions

Persistent psychotic symptoms despite adequate antipsychotic treatment in patients diagnosed with schizophrenia, also with pathological findings in MRI an organic cause such as CADASIL must be considered. Further studies are needed to better understand the exact impacts of cerebral tissue lesions and psychiatric symptoms in CADASIL patients.

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), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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