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Research on Virology and Cytopathology
Title
Research on Virology and Cytopathology
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iConcept Press
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978-1-922227-70-6
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Chapter 7

Research on Virology and Cytopathology

Cerebral Calcifications as a Differential Diagnosis of Psychiatric Disorders

by Amir Mufaddel, Ossama Osman and Ghanem Al Hassani

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Abstract

It is of vital importance to differentiate psychiatric symptoms due to organic causes from those presenting with a primary psychiatric disorder. Organic psychiatric disorders should always be in mind during assessment of patients presenting with psychiatric symptoms particularly those with first episode of symptoms, having prominent cognitive symptoms or presenting with clinical features that are not typical for functional psychiatric disorder. Several physical causes can contribute to the etiology of organic psychiatric disorders such as neurological conditions, infectious diseases, constipation, dehydration, pain and vascular causes. Delirium and dementia can occur due to several causes. Other organic mental disorders classified in ICD-10 include organic hallucinosis, organic catatonic disorder, organic delusional or schizophrenia-like disorder, organic mood disorder, organic anxiety disorder and organic personality disorder. Radiologic investigations are useful tools to exclude organic pathology in patients presenting with psychiatric symptoms. Central nervous system (CNS) calcifications can occur in a wide range of conditions with different etiologies. Calcifications can occur as physiologic, dystrophic, congenital or vascular calcifications. For psychiatric patients who present with CNS calcifications, the location of calcification and the clinical psychiatric and systemic presentation are of vital importance in diagnosis. In this paper the differential diagnosis of brain calcifications will be discussed in relation to the possible psychiatric presentations reported in the literature. Brain calcifications can occur as intra- or extra-axial calcifications. Structures commonly involved in intra-axial clarifications are the basal ganglia and the cerebellum. Causes of intra-axial calcifications include neoplasms (e.g. oligodendrogliomas and astrocytomas), vascular causes (e.g. angiomatous malformations and aneurysms), Infectious (e.g. congenital childhood infections, and parasitic infections such as neurocysticercosis and cerebral hydatid cyst disease), congenital causes (e.g. tuberous sclerosis); and endocrine/metabolic causes (e.g. hypoparathyroidism, and hyperparathyroidism). Several conditions with calcifications involving various brain regions have been reported in association with psychiatric features. Examples of these are basal ganglia calcification (Fahr’s disease) and Gorlin-Gltz syndrome. Idiopathic familial calcifications such as that occurring in Fahr’s disease. In this paper, neuropsychiatric presentations of fahr’s disease will be discussed in a separate section. Etiology, clinical features and diagnosis will be presented. Examples of structures involved in extra-axial calcifications are: falx cerebri and the pineal gland. Gorlin-Goltz syndrome is a rare condition that has multi-organ involvement and calcification involving the falx cerebri; and can present with psychiatric features as well. Clinical features diagnosis and possible pattern of presentation to psychiatry will be discussed.

Author Details

Amir Mufaddel
Behavioral Sciences Institute, Al Ain Hospital, Al Ain, United Arab Emirates
Ossama Osman
Department of Psychiatry, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
Ghanem Al Hassani
Behavioral Sciences Institute, AlAin Hospital, Al Ain, United Arab Emirates

Citation

Amir Mufaddel, Ossama Osman and Ghanem Al Hassani. Cerebral Calcifications as a Differential Diagnosis of Psychiatric Disorders. In Research on Virology and Cytopathology. ISBN:978-1-922227-70-6. iConcept Press. 2016.

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