Cerebellar Stroke-manifesting as Mania (original) (raw)

A Case of Cerebellar Psychopathology

Psychosomatics, 2010

Background: Pathology of the cerebellum has traditionally been associated with motor symptoms, vertigo, and nystagmus. Patients with cerebellar disorders do not usually receive psychiatric evaluations. Objective: The authors seek to alert clinicians to the association between cerebellar disease and psychiatric symptoms. Method: The authors describe a patient with uncommon psychiatric morbidity associated with cerebellar dysfunction, and provide a brief review of previous research on this phenomenon. Results: Neurology consultants suggested that physical exam findings and behavioral changes could be accounted for by cerebellar cognitive affective syndrome. This syndrome involves dysfunction of the cerebellum, including classic cerebellar findings, in addition to cognitive difficulties and affective/personality changes. Conclusion: The suspected etiology was post-infectious cerebellitis from Epstein-Barr virus infection.

Development of a Psychiatric Disorder Linked to Cerebellar Lesions

Cerebellum (London, England), 2018

Cerebellar dysfunction plays a critical role in neurodevelopmental disorders with long-term behavioral and neuropsychiatric symptoms. A 43-year-old woman with a cerebellum arteriovenous malformation and history of behavioral dysregulation since childhood is described. After the rupture of the cerebellar malformation in adulthood, her behavior morphed into specific psychiatric symptoms and cognitive deficits occurred. The neuropsychological assessment evidenced impaired performance in attention, visuospatial, memory, and language domains. Moreover, psychiatric assessment indicated a borderline personality disorder. Brain MRI examination detected macroscopic abnormalities in the cerebellar posterior lobules VI, VIIa (Crus I), and IX, and in the posterior area of the vermis, regions usually involved in cognitive and emotional processing. The described patient suffered from cognitive and behavioral symptoms that are part of the cerebellar cognitive affective syndrome. This case supports...

Bipolar Spectrum Disorders in Patients With Cerebellar Lesions

Journal of Nervous and Mental Disease, 2015

Nonmotor functions of the cerebellum are well known. Within this frame, the aim of this study was to compare psychiatric morbidity rates among patients affected by cerebellar diseases or Parkinson's disease (PD). Forty-seven patients (27 cerebellar and 20 PD) underwent a comprehensive psychiatric evaluation (psychopathological rating scales and the Structured Clinical Interview for DSM-IV-TR Axis I Disorders). Psychiatric disorders were slightly more frequent among cerebellar than among PD patients (89% vs. 75%; p = 0.21). Mood disorders were more frequent in the cerebellar than in the PD group (90% vs. 55%; p < 0.01). Among those subjects with no psychiatric history prior to the onset of neurological disease, bipolar spectrum disorders were more frequent within the cerebellar group (p < 0.01). These results confirm high rates of psychiatric disorders among cerebellar patients. The higher frequency of bipolar spectrum presentations found in the cerebellar group may suggest a specific involvement of cortico-cerebellar circuits in the pathophysiology of mood dysregulation.

Mania caused by a diencephalic lesion

Neuropsychologia, 2002

We describe the case of a young male patient, SN, who suffered a MR-documented ischaemic lesion of both dorsomedial thalami and presented with a transient maniform syndrome. SN's neuropsychological, structural and functional imaging findings are compared with similar reported cases and are discussed in the framework of fronto-subcortical circuits and their proposed behavioural disorders. SN's mania was characterized by restlessness, mood elevation, a tendency for pleasurable activities, inflated self-esteem and loss of disease awareness. Other symptoms were sexual disinhibition, tactlessness, abnormal discourse, and reduced need for food and sleep. His neuropsychological assessment revealed an anterograde amnesia, and an impairment of frontal-executive functions. A SPECT-study showed diaschisis-related areas of hypoperfusion in both prefrontal regions which were interpreted as equivalents of SN's frontal-dysexecutive syndrome. In addition, there was a perfusion deficit in the right orbitofrontal cortex, which was taken as the imaging correlate of SN's secondary mania and personality disorder. These findings suggest that SN's mania and his other symptoms result from the twofold disruption of fronto-subcortical connections, namely of the right orbitofrontal loop which is concerned with mood regulation and socially appropriate behaviour, and of the dorsolateral prefrontal loop which mediates executive cognitive functions.

From Cerebellar Malformation to Suicidal Idea: Case Report

Clinical Schizophrenia & Related Psychoses, 2021

In 1998, Schmahmann described an affective and cognitive cerebellar syndrome. Studies have shown that cerebellum plays a major role in higher functions since involved in cognitive and emotional processing. Papers reported studies of the direct implication of cerebellum in the psychopathology of described psychiatric disorders such as schizophrenia. Furthermore, a series of cases reported that posterior fossa malformations appear to be related to psychiatric disorders suggestive of schizophrenia. In this paper, we report a case of Dandy Walker Varient revealed by melancholic depression with suicidal ideation in a patient followed for schizophrenia. We then review the evidences supporting a possible link between the two conditions.

A Case of Psychogenic Movement Disorder Mimicking Acute Cerebellar Syndrome

Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2016

A case of psychogenic movement disorder mimicking acute cerebellar syndrome Psychogenic movement disorders (PMDs) are involuntary movements of various kinds without any underlying organic etiology. They can occur as tremor, spasm, dystonia, parkinsonism or myoclonus. A detailed history and neurological examination is essential to differentiate these disorders from organic neurological etiologies. Since PMDs are challenging entities in clinical practice, we presented this case of psychogenic tremor and gait disorder mimicking acute cerebellar syndrome in order to emphasize the importance of diagnostic clinical clues of PMDs in the differentiation of organic diseases, and to give accurate treatment.

Emotional disorders in patients with cerebellar damage - case studies

Aim. Growing number of research shows the role of the cerebellum in the regulation of affect. Lesions of the cerebellum can lead to emotional disregulation, a significant part of the Cerebellar Cognitive Affective Syndrome. The aim of this article is to analyze the most recent studies concerning the cerebellar participation in emotional reactions and to present three cases: two female and one male who suffered from cerebellar damage and presented post-traumatic affective and personality change.