Pharmacologic side effects and/or neurologic disorder: case report

Psychiatr Danub. 2009 Dec;21(4):575-8.

Abstract

The authors presented a patient with schizophrenia and with early parallel development of neurologic symptoms. At first, symptoms were manifested by extrapyramidal syndrome due to appliance of typical neuroleptics. Therefore, therapeutic approach was diverted to implementation of atipycal antiypsychotics. Consequently patient developed orofacial diskyinesias which progrediated in unilateral choreo-atetoid movements. This followed two hospitalizations for diagnostic workup and correction of therapy. Only repeated brain MR showed moderate cortical atrophy. However, even with different therapeutic changes and approaches, we were not able to reach any significant shift neither in psychiatric nor neurologic disturbances. The resistence on pharmacologic threapy led to suspicion of parallel development of neurologic disorder in form of Huntington chorea. Still remains the question whether primary neurologic disorder provoked psychotic process or there were two separate disorders where pharmacologic intervention accelerated expansion of neurologic disorder.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / therapeutic use
  • Atrophy
  • Cerebral Cortex / pathology
  • Comorbidity
  • Diagnosis, Differential
  • Drug Resistance
  • Drug Therapy, Combination
  • Humans
  • Huntington Disease / diagnosis*
  • Huntington Disease / genetics
  • Magnetic Resonance Imaging
  • Male
  • Neurocognitive Disorders / diagnosis*
  • Neurocognitive Disorders / genetics
  • Neurologic Examination / drug effects
  • Neurotoxicity Syndromes / diagnosis*
  • Schizophrenia / diagnosis
  • Schizophrenia / drug therapy*
  • Schizophrenia / genetics

Substances

  • Antipsychotic Agents