Acute, Progressive Akinetic-Rigid Syndrome Induced by Neuroleptics in a Case of Wilson's Disease

Chroni, Elisabeth; Lekka, N.P.; Tsibri, E.; Economou, Apostolis; Paschalis, C

doi:10.1176/jnp.13.4.531

Cited by 20 publications

(2 citation statements)

References 4 publications

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“…(1) Other common organic causes have been eliminated (2) Association with somatic signs including mental retardation or cognitive decline (3) Acute onset, aggravation with treatment, food intake, surgery… syndrome with akinesia and rigidity which may progress despite treatment with copper chelators (Chroni et al 2001).…”

Section: Suspect An Iem Whenmentioning

confidence: 99%

Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults

Sedel¹,

Baumann

Turpin

et al. 2007

J of Inher Metab Disea

167

110

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Inborn errors of metabolism (IEMs) may present in adolescence or adulthood as a psychiatric disorder. In some instances, an IEM is suspected because of informative family history or because psychiatric symptoms form part of a more diffuse clinical picture with systemic, cognitive or motor neurological signs. However, in some cases, psychiatric signs may be apparently isolated. We propose a schematic classification of IEMs into three groups according to the type of psychiatric signs at onset. Group 1 represents emergencies, in which disorders can present with acute and recurrent attacks of confusion, sometimes misdiagnosed as acute psychosis. Diseases in this group include urea cycle defects, homocysteine remethylation defects and porphyrias. Group 2 includes diseases with chronic psychiatric symptoms arising in adolescence or adulthood. Catatonia, visual hallucinations, and aggravation with treatments are often observed. This group includes homocystinurias, Wilson disease, adrenoleukodystrophy and some lysosomal disorders. Group 3 is characterized by mild mental retardation and late-onset behavioural or personality changes. This includes homocystinurias, cerebrotendinous xanthomatosis, nonketotic hyperglycinaemia, monoamine oxidase A deficiency, succinic semialdehyde dehydrogenase deficiency, creatine transporter deficiency, and alpha and beta mannosidosis. Because specific treatments should be more effective at the 'psychiatric stage' before the occurrence of irreversible neurological lesions, clinicians should be aware of atypical psychiatric symptoms or subtle organic signs that are suggestive of an IEM. Here we present an overview of IEMs potentially revealed by psychiatric problems in adolescence or adulthood and provide a diagnostic strategy to guide metabolic investigations.

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Section: Suspect An Iem Whenmentioning

confidence: 99%

Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults

Sedel¹,

Baumann

Turpin

et al. 2007

J of Inher Metab Disea

167

110

View full text Add to dashboard Cite

show abstract

“…Treatment at the ‘psychiatric’ stage is therefore essential. The use of antipsychotics should be avoided as far as possible (prescription limited to psychotic disorders or severe behavioural disorders), as they can cause akinesia and rigidity which may progress despite treatment with copper chelators [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Psychiatric manifestations of treatable hereditary metabolic disorders in adults

Demily

Sedel

2014

Ann Gen Psychiatry

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Detecting psychiatric disorders of secondary origin is a crucial concern for the psychiatrist. But how can this reliably be done among a large number of conditions, most of which have a very low prevalence? Metabolic screening undertaken in a population of subjects with psychosis demonstrated the presence of treatable metabolic disorders in a significant number of cases. The nature of the symptoms that should alert the clinician is also a fundamental issue and is not limited to psychosis. Hereditary metabolic disorders (HMD) are a rare but important cause of psychiatric disorders in adolescents and adults, the signs of which may remain isolated for years before other more specific organic signs appear. HMDs that present purely with psychiatric symptoms are very difficult to diagnose due to low awareness of these rare diseases among psychiatrists. However, it is important to identify HMDs in order to refer patients to specialist centres for appropriate management, disease-specific treatment and possible prevention of irreversible physical and neurological complications. Genetic counselling can also be provided. This review focuses on three HMD categories: acute, treatable HMDs (urea cycle abnormalities, remethylation disorders, acute intermittent porphyria); chronic, treatable HMDs (Wilson’s disease, Niemann-Pick disease type C, homocystinuria due to cystathionine beta-synthase deficiency, cerebrotendinous xanthomatosis); and chronic HMDs that are difficult to treat (lysosomal storage diseases, X-linked adrenoleukodystrophy, creatine deficiency syndrome). We also propose an algorithm for the diagnosis of HMDs in patients with psychiatric symptoms.

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Current Awareness

2002

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 19 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Acute, Progressive Akinetic-Rigid Syndrome Induced by Neuroleptics in a Case of Wilson's Disease

Cited by 20 publications

References 4 publications

Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults

Psychiatric manifestations revealing inborn errors of metabolism in adolescents and adults

Psychiatric manifestations of treatable hereditary metabolic disorders in adults

Current Awareness

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