Deep Brain Stimulation for Obsessive Compulsive Disorder Reduces Symptoms of Irritable Bowel Syndrome in a Single Patient.

Irritable bowel syndrome (IBS) is a frequent gastrointestinal disorder that is difficult to treat. We describe findings from evaluation of a woman (55 years old) with obsessive compulsive disorder, which was treated with bilateral deep brain stimulation in the anterior limb of the internal capsule, and IBS. After the brain stimulation treatment she reported substantial relief of her IBS symptoms. This reduction depended on specific stimulation parameters, was reproducible over time, and was not directly associated with improvements in obsessive compulsive disorder symptoms. These observations indicate a specific effect of deep brain stimulation on IBS. This observation confirms involvement of specific brain structures in the pathophysiology of IBS and shows that symptoms can be reduced through modulation of neuronal activity in the central nervous system. Further studies of the effects of brain stimulation on IBS are required.

[Frontotemporal Dementia Presenting as Acute Late Onset Schizophrenia] / Ein Fall von schizophrenieformer Störung bei frontotemporaler Demenz (FTD).

The concept of frontotemporal lobar degeneration comprises a heterogenous group of cortical dementias, including frontotemporal dementia, as the major clinical variant. Because of their highly variable clinical presentation, to establish the diagnosis of frontotemporal dementia could be a diagnostic challenge for the clinician. Here we report a 53 years old caucasian male patient who was admitted for hospitalization due to acute severe schizophrenia-like symptoms. The leading symptomatology comprised acoustic and bizarre optical hallucinations with euphoria and self-overestimation. Remission of the psychotic symptoms demasked the clinical picture of a rapidly progressive frontotemporal dementia with marked apathy, indifference, emotional blunting, loss of insight, change of personality and typical cognitive impairment. The diagnosis was supported by the results of cerebral MRI and FDG-18 PET. This first clinical manifestation of a schizophrenia-like syndrome in the 6 (th) life decade implicates frontotemporal dementia as an important differential diagnosis of schizophrenic disorders in late life. In addition of basically thinking about frontotemporal dementia, a detailed medical history, cognitive testing, neuroimaging and eventually the evaluation of the further disease course are necessary to establish a diagnosis of frontotemporal dementia.

[A case of schizophreniform disorder in frontotemporal dementia (FTD)]. / Ein Fall von schizophrenieformer Störung bei frontotemporaler Demenz (FTD).

The concept of frontotemporal lobar degeneration comprises a heterogenous group of cortical dementias, including frontotemporal dementia, as the major clinical variant. Because of their highly variable clinical presentation, to establish the diagnosis of frontotemporal dementia could be a diagnostic challenge for the clinician. Here we report a 53 years old caucasian male patient who was admitted for hospitalization due to acute severe schizophrenia-like symptoms. The leading symptomatology comprised acoustic and bizarre optical hallucinations with euphoria and self-overestimation. Remission of the psychotic symptoms demasked the clinical picture of a rapidly progressive frontotemporal dementia with marked apathy, indifference, emotional blunting, loss of insight, change of personality and typical cognitive impairment. The diagnosis was supported by the results of cerebral MRI and FDG-18 PET. This first clinical manifestation of a schizophrenia-like syndrome in the 6th life decade implicates frontotemporal dementia as an important differential diagnosis of schizophrenic disorders in late life. In addition of basically thinking about frontotemporal dementia, a detailed medical history, cognitive testing, neuroimaging and eventually the evaluation of the further disease course are necessary to establish a diagnosis of frontotemporal dementia.