Fahr's syndrome is a rare disease entity which presents with multiple neurological symptoms like movement disorder or cognitive impairment. We describe a case of a young male patient who presented with symptoms mimicking schizophrenia. He failed to improve despite medical management. He developed an episode of seizure which prompted us to make a computed tomography (CT) scan of the brain, revealing bilateral calcification of basal ganglia, despite normal serum calcium and parathyroid hormone (PTH) levels. This case experience explains the need to rule out all pathological causes of hallucinations before making a diagnosis of schizophrenia.

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A case history of an 18-year-old female with a diagnosis of Munchausen syndrome is presented with a literature review of this rare syndrome. We present this case because of the young age and the patient's overwhelming response to cognitive behavioral therapy. We recommend collateral history taking, exclusion of all possible etiologies and detailed briefing of family members as it plays a vital role to reduce the mental and financial suffering of the patient.

Abstract Objective: To determine the pattern of presentations and characteristics of patients at a psychiatric emergency services facility. Methods: The cross-sectional study was conducted in November 2016 at the Department of Psychiatry and Behavioural Sciences, Jinnah Postgraduate Medical Centre, Karachi, and comprised all patients presenting to the departmental emergency services. Data was documented on a pre-designed semi-structured proforma, and analysed using SPSS 22. Results: Of the 316 cases, 162(51.3%) were males and 154(48.7%) were females. The overall mean age was 30.78+/-13.09 years (range: 8-80 years). Psychiatric emergencies comprised suicidal attempt, excitement, violence, altered sensorium, altered/ inappropriate behaviour and extrapyramidal symptoms / acute dystonia together constituting for 123(38.9%) of the total presentations, while there were 20(6.33%) cases of hysterical fits  and 6(1.89%) with acute anxiety symptoms. Overall, 56(17.7%) subjects were found to have no psychiatric diagnosis, and 46(81.5%) of these were referred cases. Conclusion: Non-emergency visits constituted high percentage of emergency presentation. Key Words: Psychiatry, Emergencies, Referral, Violence, Dystonia. Continuous...