Neuropsychiatric symptoms associated with idiopathic calcification of the basal ganglia

Article Abstract:

Idiopathic calcification of the basal ganglia (ICBG) is a disorder of unknown origin which leads to neuropsychiatric and movement disorders that resemble schizophrenia with tardive dyskinesia (TD). TD is a condition induced by the long-term use of antipsychotic (neuroleptic) drugs, resulting in impaired, involuntary body movements. The case is reported of a 63-year-old alcoholic man with neuroleptic malignant syndrome (NMS; a potentially fatal condition related to the administration of neuroleptics). He developed auditory paranoid delusions when he was 19, and had many psychotic episodes requiring hospitalization over the next 44 years. Although his NMS responded to treatment, computerized tomography (CT) of his brain demonstrated extensive basal ganglia calcification. However, his thyroid, serum and urinary output and ammonia levels were normal. He had a twin sister who was also diagnosed with paranoid schizophrenia. Her CT scan demonstrated similar basal ganglia calcification. ICBG is a familial disease with two onset patterns. Early-onset ICBG appears between the ages of 20 to 40 and includes schizophrenia-type psychosis. Late-onset ICBG presents between the ages of 40 and 60 years and includes dementia and parkinsonian movement disorder. ICBG differs from other calcium metabolism disorders in that clinical findings are limited only to the central nervous system. ICBG dementia is characterized by inattentiveness, poor short-term memory, and slowing cognitive processes. CT evidence of basal ganglia calcification may help to distinguish schizophrenic patients with TD from patients with ICBG. This is of particular importance, since ICBG patients tend to be sensitive to neuroleptic drugs and may be more susceptible to NMS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Antipsychotic drugs, Antipsychotic agents, Neuroleptic malignant syndrome

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Family history of anxiety disorder in control subjects with lactate-induced panic attacks

Article Abstract:

Anxiety attack disorders are frequent in the general population. The average person in the course of a lifetime has a 10 to 25 percent chance of developing some type of anxiety disorder and a 1.5 percent chance of having a panic disorder, an extreme anxiety state characterized by fits of panic. Women experience symptoms of anxiety three times as frequently as men and the age group which shows the highest rate of panic disorder is between 24 and 40. It was hypothesized that some individuals may be more vulnerable or have a predisposition to anxiety disorders. A control group of 45 subjects having no history of panic attack disorder were given dosages by infusion of a mixture of sodium lactate, isoproterenol, and dextrose to induce a panic reaction. Ten of the control group, or 22.2 percent, experienced a panic attack. Data regarding the family history of eight of the individuals who experienced a panic episode and 26 of those who did not were compiled. It was found that in the relatives of the people who experienced a panic attack, there was a higher incidence of anxiety disorders. No correlation was found between the eight who reacted or the total control group and the incidence of substance abuse or mood disorder. The only relation that was observed was between the controls who had the panic attacks and the prevalence of anxiety disorders in their first-degree relatives. These results suggest that there does exist a genetic predisposition to anxiety disorders for some people and that the lactate-induced reaction may serve as a genetic indicator of this vulnerability.

Psychological aspects, Genetic aspects, Genetic markers, Panic disorders, Panic disorder, Sodium compounds, Disease susceptibility

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Cognitive deficits in obsessive-compulsive disorder

Article Abstract:

A study of neuropsychological functioning in children with obsessive-compulsive disorder is discussed.

Letter to the Editor, Obsessive-compulsive disorder, Obsessive compulsive disorder, Cognition disorders, Cognitive disorders, Neuropsychological tests for children, Childhood neuropsychological tests

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