Abstract
The Sri Lanka Journal of Psychiatry (SLJP) is a peer-reviewed, open access journal published bi annually by the Sri Lanka College of Psychiatrists.The Journal publishes original papers, brief reports including case reports and commentaries relevant to psychiatry and allied sciences. The Sri Lanka Journal of Psychiatry is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.Cover“Perseverance”. These tenacious fishermen in Mannar continue their livelihood despite numerous difficulties. L. N. P. Samarasinghe, Acting Consultant Psychiatrist, Base Hospital Nikaweratiya, Sri Lanka.
Highlights
The Dandy-Walker complex (DWC) is a series of neurodevelopmental anomalies in the posterior fossa, including the Dandy-Walker malformation, DandyWalker variant, mega-cisterna magna and posterior fossa arachnoid cyst (1)
We describe a 13-year old girl with limited intellectual capacity who presented with clinical features of schizophrenia, and who was diagnosed with the Dandy-Walker variant during organic screening for first episode psychosis
Psychosis associated with DWC is described to be characterized by juvenile or young adult onset, atypical psychotic symptoms, high frequency of family history of psychosis, high prevalence of cognitive deficit, and refractoriness to treatment according to case studies (4)
Summary
The Dandy-Walker complex (DWC) is a series of neurodevelopmental anomalies in the posterior fossa, including the Dandy-Walker malformation, DandyWalker variant (cerebellar hypoplasia and cystic dilatation of the fourth ventricle), mega-cisterna magna and posterior fossa arachnoid cyst (1). On mental state examination she was found to be experiencing systematized persecutory delusions, where she strongly believed that a group of teachers at her school were trying to poison the food she eats at home She was experiencing third person auditory hallucinations, where she used to hear this group discussing about her at school, which was more than 10 kilometers away from her home. According to Tests of Nonverbal Intelligence-4 (TONI 4) she presented with poor intelligence level [Index score -73, Normal range 90-110] Her general examination and neurological examination were normal. CT report noted a normal posterior fossa, suggesting the Dandy-Walker variant. She was diagnosed to have schizophrenia and commenced on risperidone 1 mg at night and managed as an outpatient.
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