The Clinical Significance of Bilateral Basal Ganglia Calcification Presenting With Mania and Delusions

Johnson, Justin M.; Legesse, Benalfew; Camprodon, Joan A.; Murray, Evan D.; Price, Bruce H.

doi:10.1176/appi.neuropsych.12090222

Cited by 16 publications

(7 citation statements)

References 11 publications

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“…Casamassima et al described a similar case that ultimately responded to ECT. Other authors describe patients with new‐onset, treatment‐response mania, without motor or cognitive deficits, who upon neuroimaging were determined to have BGC . Consequently, BGC in these latter patients may have been an incidental finding.…”

Section: Resultsmentioning

confidence: 99%

Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder

2016

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Secondary mania should be suspected in patients with neurological deficits, histories atypical for classic bipolar disorder, and first manic episodes after the age of 40 years. Treatment with antimanic medications, along with specific treatment for the underlying neurologic condition, is typically required. Typical lesion locations fit with current models of bipolar disorder, which implicate hyperactivity of left-hemisphere reward-processing brain areas and hypoactivity of bilateral prefrontal emotion-modulating regions. Lesion studies complement these models by suggesting that right-hemisphere limbic-brain hypoactivity, or a left/right imbalance, may be relevant to the pathophysiology of mania.

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Section: Resultsmentioning

confidence: 99%

Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder

2016

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“…Findings from basal ganglia lesion studies have demonstrated that observed alterations in behavior correspond with established nonmotor circuits between frontal and subcortical structures, which are intimately involved in cognitive and emotional processes (14). Such processes are also functions of reward‐related cortico‐subcortical circuits.…”

Section: Discussionmentioning

confidence: 99%

Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case

Balcıoğlu

Doğan

Incı

et al. 2020

Journal of Forensic Sciences

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Organic brain disturbances particularly related to frontal cortex structures and subcortical areas including the basal ganglia may play a role in behavioral disinhibition disorders. Kluver–Bucy syndrome (KBS), which is one of the better knowns of these syndromes, includes hyperorality, visual agnosia, and hypersexuality, has been reported to occur after temporal lobe and amygdala lesions; however, several patients who had focal lesions in areas other than the temporal cortex and amygdala have been reported to present partial KBS symptoms. Nucleus lentiformis refers to a large portion of the basal ganglia including the putamen and globus pallidus, and specific structures within this broad area are known to be important for reward and value‐based decision making. To date, KBS symptoms including hypersexual behavior associated with nucleus lentiformis lesions have never been reported. Here, we present a 38‐year‐old male patient who developed increased sexual interest and hyperorality after infarctions in the right lenticular nucleus and right occipitotemporal region and committed a first‐degree sexual assault. He was sent to our institution for the assessment of criminal responsibility to the index sexual crime. According to a comprehensive and thorough forensic psychiatric evaluation, he was diagnosed as having an organic personality disorder with partial KBS symptoms. To the best of our knowledge, this is the first reported case of deviant sexual behavior and hyperorality developing after nucleus lentiformis infarction. We aimed to discuss possible neurobiologic explanations of late‐onset deviant sexual behavior, which resulted in sexual criminal behavior following a cerebrovascular infarction.

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“…6,7 Al ser parte de las entidades mencionadas, la mayoría de los casos presenta síntomas que varían desde trastornos del movimiento (parkinsonismo, corea, atetosis), alteración del estado de alerta, cefalea y crisis convulsivas hasta síndromes como el de la motoneurona superior y cuadros neuropsiquiátricos. 8,9 La causa por la cual los pacientes descritos presentaban calcificación en los ganglios basales fue distinta en cada uno; según la historia clínica y la exploración física inicial se realizó protocolo específico para llegar a un diagnóstico definitivo.…”

Section: Discussionunclassified

Calcificación simétrica y bilateral de ganglios basales. Serie de casos y revisión de la literatura

Jiménez‐Ruiz¹,

Cárdenas-Saenz²,

Ruiz-Sandoval³

2018

GMM

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Ganglia calcification can be associated with age-related neurodegenerative changes, but it can be an initial manifestation of a variety of systemic pathologies, including disorders of the calcium metabolism, intoxication by different agents, and autoimmune and genetic diseases. Correlation of typical imaging findings with clinical manifestations and laboratory results should be established to reach a definitive judgment.

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The Clinical Significance of Bilateral Basal Ganglia Calcification Presenting With Mania and Delusions

Abstract: The authors present the case of a 37-year-old man who developed a psychotic manic episode and was found to have bilateral basal ganglia calcification (BGC). The authors present this case report along with a discussion of the literature on the neuropsychiatry of BGC.

Cited by 16 publications

References 11 publications

Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder

Mania secondary to focal brain lesions: implications for understanding the functional neuroanatomy of bipolar disorder

Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case

Calcificación simétrica y bilateral de ganglios basales. Serie de casos y revisión de la literatura

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