EPA-1789 – Behind psychopathology - a corticobasal degeneration

Abstract

Introduction The corticobasal degeneration (CBD) is a rare and severe neurodegenerative condition associated with a heterogeneous clinical syndrome of behavioral, motor, sensory and cognitive symptoms. Epilepsy is often associated with ictal, post-ictal and inter-ictal behavior changes, and it‘s a rare manifestation in DCB. Objectives/Aims Literature review on topic Corticobasal Degeneration, with presentation of a clinical case. Methods Research conducted in Pubmed with the words:’corticobasal degeneration’,’neuropsychiatric symptoms’. The clinical information was collected from patient and family. Results The authors report a case of a 55 years-old women with a history of anorexia nervosa, an affective disorder with features of Major Depression of 7 years of evolution and Epilepsy. Was admitted toInpatient Psychiatry Unit by rapidly progressive neurodegenerative clinical status of 6 months period, with temporo-spatial disorientation, incoherent speech, personality regression identifying substantial changes in behavioral pattern (apathy, depressed mood, anxiety), committing almost completely their autonomy. Neurological examination reported mnesic deficits, difficulty in memory recall, lack of ability to calculate and abstraction, ideational and ideomotor apraxia,’alien limb’ phenomenon, parkinsonism with global bradykinesia, gait in small steps and left hemibody stiffness. Emphasize the complementary diagnostic exams, the electroencephalographic study with bilateral paroxystic activity of central predominance and brain-MRI revealing leukoencephalopathy, Globus pallidus mineralization and cortico-subcortical atrophy. Conclusions The differential diagnosis of prion encephalopathy and limbic encephalitis were excluded, having performed therapeutic trial with methylprednisolone without improvements. It is discussed in this clinical case of DCB, the long pre-symptomatic period of pathological behavior and epilepsy, relative to rapidly progressive neurological deterioration.