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Dandy-Walker Malformation Presenting with Affective Symptoms
Mert Batmaz1, Zeynep Ezgi Balçik2, Ürün Özer1
1Department of Psychiatry, Bakırköy Prof. Mazhar Osman Mental Health and Neurological Diseases Training and Research Hospital, İstanbul, Turkey.
Noro Psikiyatri Arsivi
|October 17, 2017
Summary
Dandy-Walker malformation, a rare condition, can present with psychiatric issues like bipolar disorder. This case highlights the cerebellum's role in mood regulation and the need for careful psychiatric treatment.
Area of Science:
- Neuroscience
- Psychiatry
- Developmental Biology
Background:
- Dandy-Walker malformation is characterized by posterior fossa enlargement, fourth ventricle dilation, and cerebellar hypoplasia.
- While developmental delay is common, psychiatric comorbidities are rarely reported, with limited literature on bipolar disorder association.
- This study focuses on a rare case of Dandy-Walker malformation with comorbid bipolar disorder.
Observation:
- A 27-year-old male with childhood-diagnosed Dandy-Walker malformation presented with attention deficits, behavioral issues, and learning difficulties.
- The patient experienced subsequent manic and depressive episodes, with recent symptoms indicative of a manic episode.
- Cranial CT confirmed Dandy-Walker malformation features, including cerebellar hypoplasia and posterior fossa cyst.
Findings:
- The case demonstrates a rare comorbidity of Dandy-Walker malformation and bipolar disorder.
- Cerebellar anomalies, as seen in Dandy-Walker malformation, may contribute to the pathophysiology of mood disorders.
- The patient received a complex medication regimen including aripiprazole, valproic acid, quetiapine, biperiden, and paliperidone palmitate.
Implications:
- The cerebellum's role in mood regulation is increasingly recognized, suggesting a link between cerebellar anomalies and mood disorders.
- Careful consideration of treatment resistance and side effects is crucial for managing psychiatric disorders in Dandy-Walker malformation.
- Detailed neurological and imaging assessments are recommended for bipolar disorder cases with early onset, atypical symptoms, or developmental delays.