Journal of Psychiatric Intensive Care



Short Communication

Psychotic disorder NOS with heterotopia


Saxby Pridmore a1a2c1, Gerald McInerney a3, Mariusz Rybak a1 and Stuart Archer a1
a1 PICU, Royal Hobart Hospital, Hobart, Tasmania, Australia;
a2 Discipline of Psychiatry, University of Tasmania, Hobart, Tasmania, Australia;
a3 Department of Medical Imaging, Royal Hobart Hospital, Hobart, Tasmania, Australia

Article author query
pridmore s   [PubMed][Google Scholar] 
mcinerney g   [PubMed][Google Scholar] 
rybak m   [PubMed][Google Scholar] 
archer s   [PubMed][Google Scholar] 

Abstract

Background: Heterotopia are believed to result from faulty neuronal migration. Formerly considered to be extremely rare, with the availability of MRI reports they have appeared more frequently.

Case details: We describe a 42 year old man with episodic disinhibition (violent and sexual) with disorganized thinking and behaviour, and a 20 year history of a diagnosis of schizophrenia. Soon after admission there were vague paranoid delusions. Initially, the cognitive state was impossible to access, but cognitive deficit was later demonstrated using the Mini Mental State Examination (MMSE). Although there was no clear evid??ence of delirium, the MMSE score subsequently improved, as did the disinhibited behaviour.

Results: CT revealed no abnormality. Brain MRI, however, revealed multiple bilateral subependymal heterotopia (SEH).

Conclusion: It is possible for SEH to be associated with a schizophrenia-like syndrome. CT is not sufficient and MRI is required to exclude SEH.

(Published Online April 10 2007)


Key Words: Psychosis NOS; heterotopia; neurodevelopment.

Correspondence:
c1 Correspondence to: Prof Saxby Pridmore, PICU, Royal Hobart Hospital, GPO Box 1061L, Hobart 7001, Tasmania, Australia. Tel: +61 3 6222 8308; Fax: +61 3 6222 7040, E-mail: spridmore@iprimus.com.au