Non-epileptic Seizures versus Frontal Lobe Epilepsy in an Adolescent: A Case Report.
2019; 11 (9): e5732
Towards a neuroanatomy of autism: A systematic review and meta-analysis of structural magnetic resonance imaging studies
2008; 23 (4): 289-299
Multiple inpatient psychiatric hospitalizations can be due to system issues, patient complexity, family dynamics, and misdiagnoses to name a few. This study highlights a diagnostically challenging case and how that, in itself, contributed to hospital admissions. Although 18 months elapsed from the time of the initial presentation to the diagnosis of non-epileptic seizures (NES), the suspicion of the diagnosis may have been made earlier by clinicians. The evidence for seizures of post-ictal confusion followed by lethargy, amnesia for the event, and response to an anti-seizure medication only could have provided a higher index of suspicion for NES. Many health care providers will argue that this will create over-diagnoses of NES and usage of anti-epileptic medications. While reviewing the literature on NES, it was noted that frontal lobe epilepsy (FLE) causing psychiatric comorbidities has been poorly studied. Furthermore, this case highlights that within the field of child psychiatry, the same clinical presentation can be interpreted differently. This case helps us understand how eliciting clinical information to enable the timely ordering of imaging could help in diagnoses. This may help set up clinical guidelines for NES for the mental health providers to facilitate improvement in diagnoses and treatment.
View details for DOI 10.7759/cureus.5732
View details for PubMedID 31700761
View details for PubMedCentralID PMC6822563
Schizotypal cognitions as a predictor of psychopathology in adolescents with mild intellectual impairment
BRITISH JOURNAL OF PSYCHIATRY
2007; 191: 484-492
Structural brain abnormalities have been described in autism but studies are often small and contradictory. We aimed to identify which brain regions can reliably be regarded as different in autism compared to healthy controls.A systematic search was conducted for magnetic resonance imaging studies of regional brain size in autism. Data were extracted and combined using random effects meta-analysis. The modifying effects of age and IQ were investigated using meta-regression.The total brain, cerebral hemispheres, cerebellum and caudate nucleus were increased in volume, whereas the corpus callosum area was reduced. There was evidence for a modifying effect of age and IQ on the cerebellar vermal lobules VI-VII and for age on the amygdala.Autism may result from abnormalities in specific brain regions and a global lack of integration due to brain enlargement. Inconsistencies in the literature partly relate to differences in the age and IQ of study populations. Some regions may show abnormal growth trajectories.
View details for DOI 10.1016/j.eurpsy.2007.05.006
View details for Web of Science ID 000257916400009
View details for PubMedID 17765485
There is evidence to suggest that among young people with mild intellectual disability there are those whose cognitive difficulties may predict the subsequent manifestation of a schizophrenic phenotype. It is suggested that they may be detectable by simple means.To gain adequate cooperation from educational services, parents and students so as to recruit a sufficiently large sample to test the above hypothesis, and to examine the hypothesis in the light of the findings.The sample was screened with appropriate instruments, and groups hypothesised as being likely or not likely to have the phenotype were compared in terms of psychopathology and neuropsychology.Simple screening methods detect a sample whose psychopathological and neuropsychological profile is consistent with an extended phenotype of schizophrenia.Difficulties experienced by some young people with mild and borderline intellectual disability are associated with enhanced liability to schizophrenia. Clinical methods can both identify those with this extended phenotype and predict those in whom psychosis will occur.
View details for DOI 10.1192/bjp.bp.106.033514
View details for Web of Science ID 000251872400004
View details for PubMedID 18055951