Schizencephaly associated psychosis

Latent Schizencephaly With Psychotic Phenotype or Schizophrenia With Schizencephaly? A Case Report and Review of the Literature

“…In cases of early-onset psychosis associated with motor or intellectual deficits, with or without a history of seizures, schizencephaly needs to be included in differential diagnosis. 7 On suspicion of a developmental birth defect due to positive perinatal history in our patient, we decided to perform brain imaging examinations. The use of EEG and MRI is better suited for the diagnosis of this condition than CT, as CT cannot sufficiently rule out organic brain etiology in patients with first-episode psychosis/schizophrenia.…”

“…14 Although both of these findings are nonspecific, they are in contrast with EEG findings commonly seen in other cases of psychosis associated with schizencephaly. 6,7,13 Despite the EEG abnormalities, neurological examination revealed no signs of acute neurological deficit.…”

“…There is a high incidence of low blood levels of B and D vitamins in patients with psychosis, possibly affecting negative symptomatology. 20 Our review of case reports has revealed that in 3 cases there was an improvement of both positive and negative psychotic symptoms after risperidone 7,11 and 1 case improved after the combination of loxapine and carbamazepine 13 . In our case, we observed a good treatment response to low doses of amisulpride in combination with vitamin B 9 and D supplementation.…”

“…This search returned only 7 results, out of which 5 were relevant articles, with none being more than 25 years old. 2,6,7,[11][12][13] Altogether, these five articles presented 7 case reports of schizencephaly associated with schizophrenia (5 cases) or bipolar disorder with psychotic symptoms (2 cases). Table 1 summarizes these case reports in more detail.…”

“…1 Milder schizencephaly (of the closed-lip type) can cause developmental retardation, 6 motor deficits, EEG seizures, cognitive impairment, and rarely, also psychotic symptoms. 7 Closed-lip schizencephaly is often asymptomatic (up to 17%) 8 or diagnosed only in adults. 1 The treatment of milder cases is therefore symptomatic (rehabilitation of motor deficits, anticonvulsants, antipsychotics).…”