[Mineralization of the basal ganglia as the supposed cause of poor tolerance of zuclopenthixol in a patient with long-term untreated paranoid schizophrenia]. / Mineralizacja jader podstawy jako domniemana przyczyna zlej tolerancji zuklopentyksolu u chorej z wieloletnia nieleczona schizofrenia paranoidalna.

Formations described as intracranial calcifications can appear in the course of diseases of the central nervous system, other systems and organs (e.g. endocrine), but also as a disorder of idiopathic character. They are frequently located in subcortical nuclei and usually constitute an incidental finding. This report presents the case of a patient suffering from paranoid schizophrenia for approximately 40 years, who did not agree to any treatment and was hospitalized against her will because she was the threat to the lives of others. She was treated with zuklopentixol resulting in positive symptoms reduction and considerable improvement in social functioning. Unfortunately neurological symptoms appeared: bradykinesis, rigidity--of the type of the lead pipe, balance, posture and gait abnormalities, disturbances in precise hands movements, double-sided Rossolimo's sign, plantar reflex without the participation of the big toe on the left. Neuroimaging studies have demonstrated changes in the form of lenticular nuclei calcification and reduction of signal intensity in posterior parts of both putamens. Neurological symptoms decreased significantly after switching to atypical neuroleptic (olanzapine), and the patient did not require any additional treatment. Mineralization of the basal ganglia can often be associated with psychiatric disorders and it shouldn't be neglected because it can require modification of pharmacotherapy or additional neurological treatment.

[Abdominal dystonia in a patient with schizophrenia: a case report]. / Dystonia miesni brzucha u pacjentki cierpiacej na schizofrenie: opis przypadku.

The case of 31-year-old woman suffering from schizophrenia with movement disorder is described. The patient had a 7-year history of schizophrenia. In course of the psychiatric treatment the patient presented dystonic movements within abdominal muscles. The dystonic movements were of mixed character, including voluntary and involuntary ones what might have suggested their psychogenic origin. Subsequent to the exclusion of the neurological origin of the movement disorder and poor response to antipsychotic treatment, clozapine was introduced resulting in full remission of positive symptoms and functional improvement with a diminished intensity of the involuntary movements. Psychogenic movement disorders are uncommon in schizophrenic patients. Movement disorders may occur as an adverse reaction to antipsychotic treatment, especially with typical ones. However, the abdominal muscles dystonia is an uncommon manifestation of dystonia of idiopathic, drug-induced or psychogenic origin. In such cases, a liaison between the neurologist and psychiatrist is advocated and the therapeutic process using antipsychotic treatment is necessary.