A unique case of neurofibromatosis 1 (NF1) with Cotard syndrome – A case report

Saumitra Nemlekar,Dhruv Bardolia,Urvish Jaganiya,Ritambhara Mehta,Kamlesh Dave

doi:10.12740/app/134606

Abstract

Neurofibromatosis type 1 is a neuro-cutaneous autosomal dominant disorder that is often associated with various psychiatric disorders. Cotard syndrome is a rare neuropsychiatric disorder seen in a variety of neurological and psychological illnesses. The complex course of the neurofibromatosis predisposes the individual towards higher physical and psychiatric morbidity. Here we present a case of Cotard syndrome in a patient with neurofibromatosis. The patient was brought with an alleged history of self-harm and pervasive sadness of mood; a diagnosis of recurrent depressive disorder current episode severe with psychotic features was made. Patient was treated with oral psychotropic agents and responded well to the treatment.

Highlights

Neurofibromatosis 1 (NF1) is an autosomal dominant disorder which affects approximately 1 in 3000 people [1]
Due to the cutaneous manifestations and its progressive course, the illness adversely affects the quality of life; which in turn leads to an increase in the psychological burden [5]
The present episode was suggestive of severe depression, with psychotic features & Cotard syndrome

Summary

INTRODUCTION

Neurofibromatosis 1 (NF1) is an autosomal dominant disorder which affects approximately 1 in 3000 people [1]. Patient had been unable to do any work since the onset of the low mood During this time he would often wander on the streets apologizing to people and kept verbalizing his problems. ECT was offered as a treatment option in view of the depression and active suicidal ideation but the patient & relatives refused. He was started on Tab. Escitalopram 10 mg for depressive symptoms, Tab. Olanzapine 5 mg HS for psychotic features and T. After increasing the dose of medication within 2-3 weeks patient reported marked improvement in his mood and psychotic features; Clonazepam was discontinued as sleep was assured with the above regimen. Patient was maintained on the above treatment on out-patient basis

DISCUSSION

CONCLUSION