Cargando…
Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case
BACKGROUND: Epilepsy-associated psychoses are poorly understood, and management is focused on treating epilepsy. Chronic, interictal psychosis that persists despite seizure control is typically treated with antipsychotics. Whether resection of a mesial temporal lobe lesion may improve interictal psy...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Association of Neurological Surgeons
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705519/ https://www.ncbi.nlm.nih.gov/pubmed/36443957 http://dx.doi.org/10.3171/CASE22362 |
_version_ | 1784840301196607488 |
---|---|
author | Andrews, John P. Wozny, Thomas A. Yue, John K. Wang, Doris D. |
author_facet | Andrews, John P. Wozny, Thomas A. Yue, John K. Wang, Doris D. |
author_sort | Andrews, John P. |
collection | PubMed |
description | BACKGROUND: Epilepsy-associated psychoses are poorly understood, and management is focused on treating epilepsy. Chronic, interictal psychosis that persists despite seizure control is typically treated with antipsychotics. Whether resection of a mesial temporal lobe lesion may improve interictal psychotic symptoms that persist despite seizure control remains unknown. OBSERVATIONS: In a 52-year-old man with well-controlled epilepsy and persistent comorbid psychosis, brain magnetic resonance imaging (MRI) revealed an infiltrative, intraaxial, T2 fluid-attenuated inversion recovery intense mass of the left amygdala. The patient received an amygdalectomy for oncological diagnosis and surgical treatment of a presumed low-grade glioma. Pathology was ganglioglioma, World Health Organization grade I. Postoperatively, the patient reported immediate resolution of auditory hallucinations. Patient has remained seizure-free on 2 antiepileptic drugs and no antipsychotic pharmacotherapy and reported lasting improvement in his psychotic symptoms. LESSONS: This report discusses improvement of psychosis symptoms after resection of an amygdalar glioma, independent of seizure outcome. This case supports a role of the amygdala in psychopathology and suggests that low-grade gliomas of the limbic system may represent, at minimum, partially reversible etiology of psychotic symptoms. |
format | Online Article Text |
id | pubmed-9705519 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Association of Neurological Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-97055192022-11-30 Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case Andrews, John P. Wozny, Thomas A. Yue, John K. Wang, Doris D. J Neurosurg Case Lessons Case Lesson BACKGROUND: Epilepsy-associated psychoses are poorly understood, and management is focused on treating epilepsy. Chronic, interictal psychosis that persists despite seizure control is typically treated with antipsychotics. Whether resection of a mesial temporal lobe lesion may improve interictal psychotic symptoms that persist despite seizure control remains unknown. OBSERVATIONS: In a 52-year-old man with well-controlled epilepsy and persistent comorbid psychosis, brain magnetic resonance imaging (MRI) revealed an infiltrative, intraaxial, T2 fluid-attenuated inversion recovery intense mass of the left amygdala. The patient received an amygdalectomy for oncological diagnosis and surgical treatment of a presumed low-grade glioma. Pathology was ganglioglioma, World Health Organization grade I. Postoperatively, the patient reported immediate resolution of auditory hallucinations. Patient has remained seizure-free on 2 antiepileptic drugs and no antipsychotic pharmacotherapy and reported lasting improvement in his psychotic symptoms. LESSONS: This report discusses improvement of psychosis symptoms after resection of an amygdalar glioma, independent of seizure outcome. This case supports a role of the amygdala in psychopathology and suggests that low-grade gliomas of the limbic system may represent, at minimum, partially reversible etiology of psychotic symptoms. American Association of Neurological Surgeons 2022-11-28 /pmc/articles/PMC9705519/ /pubmed/36443957 http://dx.doi.org/10.3171/CASE22362 Text en © 2022 The authors https://creativecommons.org/licenses/by-nc-nd/4.0/CC BY-NC-ND 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ). |
spellingShingle | Case Lesson Andrews, John P. Wozny, Thomas A. Yue, John K. Wang, Doris D. Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title | Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title_full | Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title_fullStr | Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title_full_unstemmed | Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title_short | Improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
title_sort | improved psychotic symptoms following resection of amygdalar low-grade glioma: illustrative case |
topic | Case Lesson |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9705519/ https://www.ncbi.nlm.nih.gov/pubmed/36443957 http://dx.doi.org/10.3171/CASE22362 |
work_keys_str_mv | AT andrewsjohnp improvedpsychoticsymptomsfollowingresectionofamygdalarlowgradegliomaillustrativecase AT woznythomasa improvedpsychoticsymptomsfollowingresectionofamygdalarlowgradegliomaillustrativecase AT yuejohnk improvedpsychoticsymptomsfollowingresectionofamygdalarlowgradegliomaillustrativecase AT wangdorisd improvedpsychoticsymptomsfollowingresectionofamygdalarlowgradegliomaillustrativecase |