Schizophrénie à début précoce chez un adolescent ayant une déficience intellectuelle et une agénésie du corps calleux : particularités cliniques, thérapeutiques et évolutives

Abstract

IntroductionAgenesis of the corpus callosum (ACC) is a rare brain malformation characterized by a total or partial absence of formation of the corpus callosum during fetal development. ACC has been correlated with various neuropsychiatric manifestations, including schizophrenia. Here, we report a rare case of ACC revealed by neuropsychiatric disorders. VignetteMA was born of a first-degree consanguineous marriage. His early childhood was marked by a psychomotor development delay, school and extra-family relationship difficulties. Over the years, there has been a gradual worsening of social and school deficits, with isolation from peers. At the age of 15, MA brutally developed physical and verbal aggression, soliloquy with unmotivated laughter and bizarre behavior, as well as vague ideas of persecution towards his teachers and peers. He was thus referred to our psychiatric consultation. The general physical and systemic examination was normal. Neuropsychological tests indicated current low Intelligence Quotient (60) with impaired executive functions. The electroencephalogram was normal. Computed tomography and magnetic resonance imaging revealed ACC. He was diagnosed with schizophrenia according to the diagnostic criteria of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The patient was put on Risperidone and then on Olanzapine at adequate doses and durations, with poor therapeutic response. ConclusionOur observation provides additional support for neurodevelopmental models of schizophrenia, and confirms literature data indicating that severe structural brain abnormalities would lead to early onset psychotic symptoms which are often refractory to pharmacological treatments.