A Psychotic Attack After Steroid Therapy in Clinically Isolated Syndrome Manifesting as Optic Neuritis
Journal Title: Journal of Neurological Sciences-Turkish - Year 2008, Vol 25, Issue 2
Abstract
Background: Corticosteroids have been widely used in attacks of Multiple Sclerosis (MS) and Clinically Isolated Syndromes but may rarely cause psychiatric manifestations, such as depression, mania, psychosis and delirium. Steroid-induced mood disorders have common clinical features, such as subacute onset, manic predominance and having psychotic history. Case Presentation: A 28 year-old housewife who had presented with a sudden blurring of vision had been diagnosed MS and applied 1000 mg/day intravenous methylprednisolone therapy for 10 days as a MS attack therapy in another hospital 20 days ago. One week after the steroid therapy she was taken to our outpatient clinic with paranoia, aggressive behaviors and disorientation. Neurological examination was normal except right optic neuritis. Brain MRI revealed periventricular and cerebellar demyelination. In her medical history she had behavioral pathologies as paranoia, aggression, visual hallucinations 5 years ago and her symptoms recovered without any psychiatric treatment less than one month. She didn't have another attack except optic neuritis, therefore we considered her diagnosis as Clinically Isolated Syndrome. After psychiatry consultation olanzapine at 20 mg/day was initiated and psychiatric excitations were taken under control. Conclusions: Intravenous methylprednisolone is usually administered in 0,5-1 gr/day dosage for 3-10 days in MS. It is considered that there's no significant difference between the administration periods in terms of the efficacy. We consider that it's important to take the psychiatric history before the steroid therapy and to reevaluate the necessity of the high dose steroid therapy and to choose the minimum dosage and period for the patients that have psychotic attack history.
Authors and Affiliations
Gencer GENC, Vedat BEK, Kemal HAMAMCIOGLU, Sinan YETKIN, Mehmet ONAL, Seref DEMIRKAYA, Zeki ODABASI
Keywords
Related Articles
- EP ID EP134052
- DOI -
- Views 94
- Downloads 0
Status Epilepticus and Semi-Reversible Cranial Magnetic Resonance Imaging Lesions: A Case Report
Status epilepticus (SE) is one of the common neurological emergencies. Neuroimaging may detect structural lesions in the investigation of SE etiology. In addition, signal changes, which are usually transient and seldom p...
Plasma Homocysteine, Folate and B12 Vitamin Levels in Alzheimer Disease, Vascular Dementia and Mild Cognitive Impairment
Purpose: Elevated plasma total homocysteine(Hcy) concentrations are associated with Alzheimer’s disease(AD) and vascular dementia(VaD). The purpose of this study is to examine the association of dementia with blood level...
Morphology Of Cultured Cells Of Glioblastoma Multiforme
The aim of the present study is to asses the morphology of cultured glioblastoma multiforme cells obtained from five patients. Established tissue cultures of malignant astrocytoma cells showed polymorphic characters phen...
Ketorolac Tromethamine Promotes Functional Recovery and Enhances Nerve Regeneration After Sciatic Nerve Trauma in Rats
Objective: The aim of this study is to investigate the effects of ketorolac tromethamine (KT) in sciatic nerve trauma model. Material and Methods: Twenty-seven Wistar rats with normal motor activity were used. Group Sha...
Orofaringiyal Yutmada Yaşa Bağlı Fizyolojik Değişiklikler: Elektrofizyolojik Bir Çalışma
Normal yaşlanmanın orofaringiyal yutma üzerine olan etkilerini disfaji ile ilişkili olan bozukluklarından ayırt etmek önemlidir. Bu çalışmada farklı yaş gruplarından oluşan normal erişkin bireylerde orofaringiyal yutmanı...