Guillain barre syndrome (GBS) is a rare autoimmune condition that has a prevalence of 1-2 per 100,000 people each year. Cerebral sinus venous thrombosis (CSVT) occurs at a rate of three to four cases per one million individuals annually. Both have variable clinical presentation with significant morbidity. The therapeutic management of CSVT and GBS presents unique challenges due to peculiar relationship and overlap in presentation. Reports suggest that psychosis may result from autoimmune encephalitis after receiving the COVID-19 vaccination. Hereby the reported case is of a female who is 18 years of age presenting with acute psychotic and catatonic symptoms following covid 19 vaccination with weakening of limbs which suspected an underlying organic pathology. Magnetic resonance imaging was normal but magnetic resonance venogram showed transverse and sigmoid sinus thrombosis and later GBS with CSVT after Covid-19 vaccination was diagnosed. The case was chosen to report a rare condition with an atypical presentation.
The Tuberous Sclerosis Complex (TSC) is a multisystem autosomal dominant condition occurring due to mutations in the TSC1 or TSC2 genes affecting around 1 in 20,000 people. TSC is inclusive of tumours of skin, kidney, brain, lung and heart as well as neurological conditions like seizures, autism spectrum disorder and intellectual disability. An array of neuropsychiatric illness known as TSC-associated neuropsychiatric diseases (TAND) are identified in around 90% of people with TSC. Among them, psychosis has been reported only in around 2.3% of cases globally and rarely from India.The Indian data of psychosis in patients of TSC is very sparse. Hereby, we report a case of a 20-year-old male who presented with symptoms of acute psychosis, catatonia and drug induced extrapyramidal symptoms (EPS) and MRI brain showed features suggestive of tuberous sclerosis complex.
Background: Behavioral and psychological symptoms of dementia (BPSD) is defined as "symptoms of disturbed perception, thought content, mood or behavior that frequently occur in patients with dementia. " Behavioral and psychological symptoms of dementia is associated with significant caregiver burden, early institutionalization, and rapid cognitive decline. The worldwide prevalence of dementia is 5-7%; whereas in India, it is reported to be 0.8-4%. Alzheimer's dementia amounts to 60% of the total prevalence of dementia. We aim to study the neuroimaging correlates of BPSD in Alzheimer's dementia. Objective: To study the correlation between BPSD with white matter changes on neuroimaging in Alzheimer's dementia. Materials and methods: It is a cross-sectional study with a sample size of 30 patients. The magnetic resonance imaging (MRI) changes were seen using volumetric analysis and white matter hyperintensity change using Fazekas scale, global cortical atrophy (GCA) score, medial temporal atrophy (MTA) score, and KOEDAM scale. Results: It was found that clinical dementia rating (CDR) scale has positive correlation with Fazekas, GCA, and KOEDAM. Addenbrooke's cognitive examination (ACE-3) has correlation with GCA. On neuropsychiatric inventory (NPI) questionnaire, depression followed by nighttime behavior were the most common BPSD symptoms. Sociodemographic factors such as age >65 years, middle socioeconomic status (SES) population, and urban population have higher mean neuropsychiatric inventory-frequency and severity (NPI-F*S) scores. Conclusion:Our study here in concordance with other studies worldwide gives a clue about the role of neuroimaging biomarkers in understanding BPSD in terms of its neuroimaging correlates and builds the scope of future studies in this domain. The study sheds light on the common presentation of BPSD, which adds to our knowledge in clinical assessment of Alzheimer's disease (AD) patients. Finally, it also adds to our understanding of the role of sociodemographic factors in predicting the at risk population.
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