Chronic subdural haematoma mimicking extrapyramidal symptoms

BMJ Case Rep. 2023 Dec 1;16(12):e255286. doi: 10.1136/bcr-2023-255286.

Abstract

A male patient in his 70s with chronic schizophrenia, who could previously walk independently, developed a gait disturbance without any significant neurological deficit. Initially, his short step length and unstable gait were thought to be related to extrapyramidal symptoms caused by medication side effects. We tapered his antipsychotic medication, but the unstable gait persisted. After 2 weeks of observation, we noted general weakness with left-side dominance, leading us to consider a focal brain lesion despite there being no recent history of falling or trauma. A CT scan of the brain showed chronic subdural haematoma and the patient underwent emergency surgery. After 14 days of treatment, he was discharged back to the chronic ward.

Keywords: Drugs: psychiatry; Neuroimaging; Schizophrenia.

Publication types

  • Case Reports

MeSH terms

  • Antipsychotic Agents*
  • Brain
  • Hematoma, Subdural, Chronic* / diagnostic imaging
  • Hematoma, Subdural, Chronic* / surgery
  • Humans
  • Male
  • Nervous System Diseases*
  • Schizophrenia*

Substances

  • Antipsychotic Agents