Comorbid schizophrenia and obsessive compulsive disorder associated with mega cisterna magna: a case report

Abstract

Historically, the cerebellum has been regarded as the region of the brain responsible for motor coordination, balance, gait, and fine motor control. Today, novel findings point to the importance of the cerebellum’s involvement in the pathophysiology of psychiatric disorders.1 There is converging evidence suggesting that a cerebellar dysfunction could underlie some of the psychiatric and neurological symptoms as well as cognitive dysfunctions observed in schizophrenia.2 The involvement of cerebellar dysfunction has also been suggested in the pathogenesis of Obsessive–Compulsive Disorder (OCD) and schizophrenia-OCD comorbidity.3 Dandy-Walker complex (DWC) is a series of anomalies in the posterior fossa, including Dandy–Walker malformation, Dandy–Walker variant, mega-cisterna magna and posterior fossa arachnoid cyst. Mega cisterna magna is the mildest form of “Dandy-Walker complex” and a developmental variation of the posterior fossa characterized by the enlargement of the cisterna magna, morphologically intact vermis and cerebellar hemispheres.4 To the best of our knowledge, there is only one case report in the literature describing a patient with the Dandy Walker complex and schizophrenia comorbid with OCD. Our aim here is to present a case of schizophrenia comorbid with OCD and mega cisterna magna, successfully treated with clonazepam.