Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech
Our patient Mr. A is a mentally and physically disabled gentleman. He was first diagnosed with bipolar disorder as a teenager. He incurred a lumbar spinal injury due to a motor vehicle incident in his 20s which led to weakness, numbness, and frequent infection over both of his lower extremities. He...
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Wiley
2022-01-01
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| Series: | Case Reports in Psychiatry |
| Online Access: | http://dx.doi.org/10.1155/2022/8162871 |
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| author | Xiaolin Deng Paulo J. Negro Patrick L. Jung Christopher M. Marano Stephanie Knight Seshagiri R. Doddi Nana Y. A. Nimo Rachel M. LeMalefant Drew A. Myers Andrea K. Haake Rebecca Chandler |
| author_facet | Xiaolin Deng Paulo J. Negro Patrick L. Jung Christopher M. Marano Stephanie Knight Seshagiri R. Doddi Nana Y. A. Nimo Rachel M. LeMalefant Drew A. Myers Andrea K. Haake Rebecca Chandler |
| author_sort | Xiaolin Deng |
| collection | DOAJ |
| description | Our patient Mr. A is a mentally and physically disabled gentleman. He was first diagnosed with bipolar disorder as a teenager. He incurred a lumbar spinal injury due to a motor vehicle incident in his 20s which led to weakness, numbness, and frequent infection over both of his lower extremities. He also developed alcohol addiction over the course of his life. Mr. A presented to our facility with complicated neuropsychiatric symptoms. By adopting various clinical strategies, we were able to control his symptoms of agitation, self-harm, mood swings, and stereotyped behavior. However, we were not able to improve his neurocognitive functioning or speech impairment which seemed to become severe and irreversible in a period of a few months. We felt disappointed and perplexed by the mixed treatment responses. To understand Mr. A’s clinical presentation, various laboratory tests and imaging studies were performed. Different psychotropic medications were used to manage his symptoms. Gradually, we felt that we were able to understand this case better clinically and etiologically. His bipolar disorder, alcohol addiction, and physical injury had likely all contributed to his neuropsychiatric symptoms, directly or indirectly. It is highly possible that an alcohol-related progressive dementia along with his chronic bipolar disorder played a key role in the progression of his brain neurodegeneration. Also, Wernicke-Korsakoff syndrome could reasonably be considered having developed during his clinical course. Moreover, the fluctuation of the patient’s neuropsychiatric symptoms we observed during his hospitalization reflects the increased vulnerability of the human brain under sustained neurodegeneration. |
| format | Article |
| id | doaj-art-9111bae909524c2e898a38cd677da9fe |
| institution | Kabale University |
| issn | 2090-6838 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Psychiatry |
| spelling | doaj-art-9111bae909524c2e898a38cd677da9fe2025-02-03T01:06:35ZengWileyCase Reports in Psychiatry2090-68382022-01-01202210.1155/2022/8162871Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speechXiaolin Deng0Paulo J. Negro1Patrick L. Jung2Christopher M. Marano3Stephanie Knight4Seshagiri R. Doddi5Nana Y. A. Nimo6Rachel M. LeMalefant7Drew A. Myers8Andrea K. Haake9Rebecca Chandler10Department of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryDepartment of PsychiatryOur patient Mr. A is a mentally and physically disabled gentleman. He was first diagnosed with bipolar disorder as a teenager. He incurred a lumbar spinal injury due to a motor vehicle incident in his 20s which led to weakness, numbness, and frequent infection over both of his lower extremities. He also developed alcohol addiction over the course of his life. Mr. A presented to our facility with complicated neuropsychiatric symptoms. By adopting various clinical strategies, we were able to control his symptoms of agitation, self-harm, mood swings, and stereotyped behavior. However, we were not able to improve his neurocognitive functioning or speech impairment which seemed to become severe and irreversible in a period of a few months. We felt disappointed and perplexed by the mixed treatment responses. To understand Mr. A’s clinical presentation, various laboratory tests and imaging studies were performed. Different psychotropic medications were used to manage his symptoms. Gradually, we felt that we were able to understand this case better clinically and etiologically. His bipolar disorder, alcohol addiction, and physical injury had likely all contributed to his neuropsychiatric symptoms, directly or indirectly. It is highly possible that an alcohol-related progressive dementia along with his chronic bipolar disorder played a key role in the progression of his brain neurodegeneration. Also, Wernicke-Korsakoff syndrome could reasonably be considered having developed during his clinical course. Moreover, the fluctuation of the patient’s neuropsychiatric symptoms we observed during his hospitalization reflects the increased vulnerability of the human brain under sustained neurodegeneration.http://dx.doi.org/10.1155/2022/8162871 |
| spellingShingle | Xiaolin Deng Paulo J. Negro Patrick L. Jung Christopher M. Marano Stephanie Knight Seshagiri R. Doddi Nana Y. A. Nimo Rachel M. LeMalefant Drew A. Myers Andrea K. Haake Rebecca Chandler Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech Case Reports in Psychiatry |
| title | Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech |
| title_full | Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech |
| title_fullStr | Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech |
| title_full_unstemmed | Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech |
| title_short | Clinical evaluation and management of a 45-year-old man with confusion, psychosis, agitation, stereotyped behavior, and impaired speech |
| title_sort | clinical evaluation and management of a 45 year old man with confusion psychosis agitation stereotyped behavior and impaired speech |
| url | http://dx.doi.org/10.1155/2022/8162871 |
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