Charles Bonnet Syndrome as a Manifestation of Leptomeningeal Metastases

Rashid, A.; Valentine, Alan D.

doi:10.1016/s0033-3182(10)70729-5

Cited by 1 publication

(4 citation statements)

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“…Psychiatric symptoms, such as agitation, confusion, and depression, can be accompanied by the presence of LM 12,13 . Previous case reports have also documented the presence of visual hallucinations in association with LM 10,14 . In contrast to our presented case, these reports involved complex visual hallucinations and were accompanied by other spinal symptoms.…”

Section: Discussioncontrasting

confidence: 90%

“…12,13 Previous case reports have also documented the presence of visual hallucinations in association with LM. 10,14 In contrast to our presented case, these reports involved complex visual hallucinations and were accompanied by other spinal symptoms. The manifestation of abnormal behavior possibly induced by a potentially hallucinatory vision in our case warrants consideration of alcohol withdrawal syndrome or psychosis; however, these diagnoses should be made cautiously as hallucinations are typically characterized by complex and negative visual experiences.…”

Section: On Admission He Showed a Confusional State With A Glasgowcontrasting

confidence: 99%

“…We presumed that the patient experienced visual hallucinations based on his tendency to reach out for something in the air. However, it is possible that this behavior was induced by visual loss resulting from metastasis to the optic nerve and abducens denervation, as reported in previous case studies 9,10 . Due to cognitive decline, the patient was unable to express what he had seen or felt throughout the course of the disease.…”

Section: Discussionmentioning

confidence: 86%

“…A RARE CASE OF LEPTOMENINGEAL METASTASIS | 3 of 5 possible that this behavior was induced by visual loss resulting from metastasis to the optic nerve and abducens denervation, as reported in previous case studies. 9,10 Due to cognitive decline, the patient was Although MRI is considered one of the gold standards for diagnosing LM, it is important to be aware of its limitations and potential pitfalls. The sensitivity of gadolinium-enhanced MRI is relatively moderate, ranging from 58.6% to 72.1%, which explains why the diagnosis of LM could not be ruled out based on negative MRI findings.…”

Section: On Admission He Showed a Confusional State With A Glasgowmentioning

confidence: 99%

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Crucial differential diagnosis of rapidly progressive dementia: A case of leptomeningeal metastasis

Mimura,

Oi,

Takata

et al. 2023

PCN Reports

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BackgroundDementia that advances subacutely without accompanying neurological symptoms can often be misdiagnosed as a psychiatric condition. Leptomeningeal metastasis (LM), caused by the spread of malignant cells to the leptomeninges and the subarachnoid space, is a relatively unfamiliar condition to psychiatrists in this context. The diagnosis of LM remains challenging due to the scarcity of diagnostic tools possessing high sensitivity and specificity.Case PresentationWe present the clinical presentation of a male in his seventies with LM secondary to gastric ring cell carcinoma. The patient exhibited an acute confusional state, visual hallucinations, irritability, and cognitive impairments over a 3‐week period. Initially, the patient was misdiagnosed with several conditions, including alcohol withdrawal syndrome, psychosis, and delirium associated with dementia, as there were no noteworthy findings on neurological examination or the head magnetic resonance imaging (MRI). Given the rapidly progressive cognitive decline, we maintained vigilance for potential neurological conditions, and a repeat investigation using head MRI and cerebrospinal fluid analysis led to the diagnosis of LM.ConclusionThis critical case report underscores the rarity of psychiatric‐onset LM originating from gastric cancer and highlights the importance of comprehensive neurological evaluations.

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Section: Discussioncontrasting

confidence: 90%