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Schizencephaly associated with bipolar II disorder.
M Arora1, S K Praharaj, V K Sinha
1Psychiatric Diseases Hospital, Government Medical College Jammu, Jammu & Kashmir, India. drmanu2004@rediffmail.com
Singapore Medical Journal
|March 20, 2009
Summary
This case study highlights a patient with bipolar II disorder and schizencephaly, a rare brain malformation. Effective treatment involved mood stabilizers and antidepressants, demonstrating successful management of complex psychiatric and neurological conditions.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Bipolar II disorder is a mood disorder characterized by depressive and hypomanic episodes.
- Schizencephaly is a rare congenital brain malformation involving abnormal gray matter clefts.
Observation:
- A 55-year-old male with a history of congenital hemiparesis, seizures, depression, and hypomania presented with severe depression and psychotic symptoms.
- Brain CT revealed a cerebrospinal fluid-filled cleft in the left cerebral hemisphere, indicative of schizencephaly.
Findings:
- The patient was diagnosed with bipolar II disorder, severe depression with psychotic features, and schizencephaly.
- Treatment with sodium valproate, quetiapine, and escitalopram resulted in significant improvement within three weeks, with sustained well-being at three months.
Implications:
- Schizencephaly should be considered in the differential diagnosis of bipolar disorder, especially when accompanied by neurological deficits like hemiparesis or seizures.
- Neuroimaging is crucial for diagnosing schizencephaly and understanding its potential contribution to psychiatric conditions.
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