Open Access Case Study

Treatment of Catatonia Using Low Doses of Clozapine

Nazmie F. Ibishi, Nebi R. Musliu, Zylfije Hundozi

International Neuropsychiatric Disease Journal, Page 35-39
DOI: 10.9734/INDJ/2015/13171

Catatonia is a state of apparent unresponsiveness to external stimuli in a person who is apparently awake and which occurs in children, adolescents, and adults and is characterized by a variety of symptoms and signs of impairment of the expression of voluntary thoughts and movements.

Antipsychotics should be used with care as they can worsen catatonia and are the cause of neuroleptic malignant syndrome, a dangerous condition that can mimic catatonia and requires immediate discontinuation of the antipsychotic.

The use of atypical antipsychotics to treat catatonia remains anecdotal, owing to concerns that they may worsen catatonic symptoms.

We  describe  the  case  of  good  treatment  response  in  low  doses  of  clozapine in  a  adolescent  with  first  psychotic  episode –catatonic  feature.


Open Access Case Study

Lymphoma with Bilateral Contrast Enhancement and Restricted Diffusion of Multiple Cranial Nerves in MRI

Sharifov Rasul, Koçer Abdulkadir, Altıntaş Özge, Alkan Alpay

International Neuropsychiatric Disease Journal, Page 69-73
DOI: 10.9734/INDJ/2015/15303

We present a 50-year-old female with paresthesia on the right side of her face, facial asymmetry, hearing loss, and difficulty in walking. After clinical and radiological evaluations, non-Hodgkin lymphoma type B has been diagnosed. Cranial MRI revealed contrast enhancement of 3rd, 5th, 7th, and 8th cranial nerves bilaterally. Diffusion-weighted imaging (DWI) revealed prominent hyperintense symmetric cranial nerves involvement with corresponding signal reduction on Apparent Diffusion Coefficient (ADC) maps. In lymphoma cases, any of the 12 cranial nerves may be affected.  Although such clinical phenomena have been described previously, this is the first patient to demonstrate restricted diffusion related to multiple cranial nerves.


Open Access Minireview Article

Psychosis in the Intensive Care Unit: Diagnostic and Therapeutic Dilemmas

Bujar Cakani, Gjon Preçi, Nevila Çaushi, Eris Ranxha, Gentian Vyshka

International Neuropsychiatric Disease Journal, Page 40-46
DOI: 10.9734/INDJ/2015/13955

Intensive care unit is a particular medical environment, sometimes creating particular stress to patients prone to psychological and psychiatric phenomenology. ICU psychosis, delirium and depression have been originally diagnosed in patients undergoing cardiac surgery. There is a large casuistic of case reports with patients presenting ICU psychosis, actually not strictly related with a recent history of major cardiac intervention, but with other types of surgery as well. Continuous and systematic attempts are made to formulate etiological explanations, together with the search of ways to prevent or to treat ICU psychosis. We describe in this paper two cases, presenting the features of post-operative ICU psychosis. A review of the history of this syndrome is made, and the controversies related to terminological discussions are mentioned. We include a short pharmacological description of the drugs imputed as causative factors of ICU psychosis, as well as of the available therapeutic options. Non-pharmacological factors probably related to the presence of this syndrome are summarized, with a brief commentary of the relative importance of each of these factors vis-à-vis this particular psychiatric syndrome.


Open Access Original Research Article

Chronic Administration of Bacopa monniera Alleviates Depressive Like Behavior and Increases the Expression of ERK1/2 in Hippocampus and Pre-Frontal Cortex of Chronic Unpredictable Stress Induced Rats

Somoday Hazra, Sourav Kumar, Goutam Kr. Saha, Amal Ch. Mondal

International Neuropsychiatric Disease Journal, Page 47-58
DOI: 10.9734/INDJ/2015/14414

Aims: Aim of the present study is to investigate the effect of Bacopa monniera in chronic unpredictable stress (CUS) induced depression in Sprague Dawley rats and its effect on ERK protein level.

Study Design: Rats were subjected to CUS procedure and daily administration of BM intragastrically for consecutive 28 days.

Place and Duration of Study: Department of Physiology, Raja Peary Mohan College, Uttarpara, Hooghly, West Bengal, India from February 2012-to July 2014.

Methods: Various types of unpredictable stressors were applied for consecutive 28 days during CUS procedure including foot shock (1 mA, 1s duration, average 1 shock/min) for 60 min, 5 min cold water swim (at 4°C), 1 min tail pinch (1 cm from the end of the tail), 48 hour food deprivation, 24 hour water deprivation, and overnight illumination. The effect of BM treatment in CUS-induced depression was examined applying behavioral tests on rats including the sucrose consumption test that indicates anhedonia like behavioral change, open field test points out decreased locomotor activity which is indicative of a behavioral change that may reflect certain aspects of refractory depression and elevated plus maze test indicates decreased anxiety. We examined the possible mechanism of BM by measuring corticosterone level (ELISA), ERK1/2 and P-ERK1/2 level in rat hippocampus and prefrontal cortex (Western blot).

Results: Four weeks of CUS exposure induced depression-like behavior in rats which is evidenced by significant decreases in sucrose consumption, decreased locomotor activity and short time spent in open arms (P=.05).In addition, it was found that corticosterone levels, ERK1/2, Phospho-ERK1/2 was significantly lower (P=.05) in CUS-treated rats. Daily administration of 80 mg/kg body weight of BM during the CUS interval significantly suppressed behavioral changes and reduced corticosterone levels, ERK1/2 and Phospho-ERK1/2 protein lev­els in the hippocampus and prefrontal cortex.

Conclusion: The present study advocates that BM can attenuate depression and also confirms that 80 mg/kg doses of BM extract have significantly higher antidepressant-like activity.


Open Access Original Research Article

Normative Values for Active Lumbar Range of Motion Using the Back Range-of-Motion Measurement (BROM) Device in School Age Children: A Cross-Sectional Study

Vaideshi C. Varangaonkar, Sailakshmi Ganesan, K. Vijaya Kumar

International Neuropsychiatric Disease Journal, Page 59-68
DOI: 10.9734/INDJ/2015/15158

Background: Quantifying changes in spinal mobility throughout the child’s development, and/or during a course of therapy is a valuable component in the pediatric physical therapy management. The purpose of this study was to establish normative values of lumbar spinal mobility on healthy schoolchildren between the ages of 6-12 years.

Methods: 294 children within the age group of 6-12 years were selected from two government schools and two private schools of Mangalore, Karnataka, India. Normative values for each movement of lumbar spine in all the cardinal planes were measured using BROM measurement procedure.

Results: Age and gender had a highly significant effect on the lumbar ranges of motions in flexion, lateral flexion and rotations with p<.05 except for the effect of gender on Extension range. There was no correlation was found between body mass index and hamstring length with lumbar ranges in males and females of any of the age groups.

Conclusion: We developed normative values of spinal mobility for each sex and age grouping from 6-12 years of healthy children. These measures of spinal mobility might help the therapist to identify early restrictions in back mobility in children with neuromusculoskeletal problems and other pediatric populations who are at risk for restrictions in spinal mobility. Early identification could lead to better prevention and also more timely effective treatment programs.