Jeyanthi, P (2012) Psychiatry Case Record. Diploma thesis, Thanjavur Medical College, Thanjavur.
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Abstract
Neurocysticercosis presenting with Psychosis: Cysticercosis is the most common parasitic disease of human central nervous system. The word cysticercosis derived from Greek KYSITS (cyst) and KERKOS (tail). Cysticercosis is endemic in some parts of all continents except Australia and Antartica. Cysticercosis consists of infection with the small bladder-like larvae of the pork tapeworm Taeniasolium. The life cycle of parasite is maintained between man and pig infected with cysticerci. Epilepsy is the most common presentation of neurocysticercosis; focal signs, headache, involuntary movements and global mental deterioration are other symptoms. Psychosis is a rare presentation and may be seen in up to 5% of patients. Obsessive Compulsive Disorder with Comorbid Recurrent Depression Current Episode Severe: DURATION: 5 years, Symptoms started gradually and increased in nature. COURSE: Continuous, Waxing and Waning present, patient never touched normalcy in between, no major precipitating factors. History of repeated thoughts of contamination with dirt present for which he washed hands repeatedly. History of repeated thoughts of something harm might happen to him or his parents. History of excessive brushing the teeth, showering, bathing by repeatedly applying the soap and for which he takes about two hours. Staying in toilet for more than one hour until somebody calls him. History of drinking water repeatedly 10-15 times per day. History of checking and counting things repeatedly and arranges it in a particular order again and again. Chants prayer several times mentally. If he goes to temple goes round it exactly eleven times and prays three times. Before going to bed he stand and count for hundred. History of feeling he has to do all these otherwise something harm might happen to his family. He feels these thoughts of his own, tries to resist but couldn’t. It causes great distress in him. Feels relieved by these acts. History of doing things very slowly present. It interferes with his social and motor functioning. History of fatigue, generalized weakness, inability to do work present. History of sad feelings present throughout the day, History of hopelessness, worthlessness present. History of inability to indulge in pleasurable activity, history of reduced self esteem and confidence, has feeling he might better die. No history of suicidal attempts or feeling others is talking about him. Paranoid Schizophrenia: Patient was apparently alright about 4 years back. She developed suspicious ideas about her husbands’ fidelity. She became emotionally withdrawn denied her family members that they are not her relatives. She stayed aloof and didn’t do any house hold work. At times, she found standing under the sun for long time. Once she wandered away without informing anybody. Also reported that her parents are against her and her mother does not take care of her properly. She used to accuse mother of giving affection only for her elder brother and because of which he is a lawyer now. Patient also would report to her parents that people talk and discuss about her on the streets and she apparently would pick up fights for the same. She was found smiling and muttering to herself at various times. She hears unknown female voices when no one could hear which threatens her and gives commands. She feels that people can know her thoughts without she telling it out. She would not take bath and did not have good personal care. She was also found to have disturbed sleep, frequent quarrels with her parents and assaulted them at times thinking that they were against her. Bipolar Affecting Disorder Current Episode Mania without Psychotic Features: He was apparently normal 3months back. He developed sleep disturbances. Found doing works and studying throughout the night .He became over talkative. He found himself more distractible at class room and could not sustain his attention. He developed over inflated ideas about his knowledge. And claimed that he can acquire any job. He prayed three to four times a day He took bath several times in a day and became much aware of his personal appearance. He exhibited disinhibition in his behavior and changed his dresses publically. He became over spending for his friends by borrowing the money from others. He sang songs and cracked jokes inappropriately. For the one month, he became more aggressive and assaultive towards his family members whenever questioned about his behavior. Dissociative Convulsion: Patient was apparently normal one month back. She has night blindness and she was criticized about this by her hostel in mates. Following which she complaint of giddiness. This was associated with involuntary movements involving all 4 Limbs, Side to side movement of head, screaming, crying and pelvic thrusting lasted for more than 30 minutes to 1 hour. This episode not associated with the followings: 1. Loss of consciousness, 2. Tongue biting, 3. Un concerned urination, 4. Frothing in mouth. No history of upward gaze of eye ball. No history of post ictal confusion. No history of any nocturnal event. Never injured herself. Never occurred when she was alone. She had repeated such episodes and some time 2 to 3 times / day She was consulted Neurology department.
| Item Type: | Thesis (Diploma) |
|---|---|
| Uncontrolled Keywords: | Neurocysticercosis presenting with Psychosis, Obsessive Compulsive Disorder with Comorbid Recurrent Depression Current Episode Severe, Paranoid Schizophrenia, Dissociative Convulsion. |
| Subjects: | MEDICAL > Psychiatry |
| Depositing User: | Subramani R |
| Date Deposited: | 17 Jan 2020 00:20 |
| Last Modified: | 30 Nov 2020 13:42 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11851 |
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