Delayed-Onset Obsessive-Compulsive Symptoms After Brain Infarctions Treated With Paroxetine

Abstract

A 68-year-old woman showed obsessive thought that she could not remember the names of people or items that she saw. She repeatedly asked her husband to recall names of unspecified people and checked the garbage to find the names of items. The patient had a history of cerebral infarctions in the left middle cerebral artery regions 2 and 15 months before the emergence of her symptoms. A magnetic resonance imaging examination showed signs of an old infarction in the left basal ganglia and ischemic signs in the right temporal lobe. Her obsessive-compulsive symptoms relating to words were successfully treated with a serotonin selective reuptake inhibitor, paroxetine, at the dose of 40 mg/d. Her scores on the Yale-Brown Obsessive Compulsive Scale reduced from 31 to 8 points after this treatment. This case may suggest therapeutic modulation of language-related cortical activity elicited by paroxetine.

Obsessive compulsive disorder due to a cavernous malformation hemorrhage in the dominant caudate head

“…Although the ICM was responsible for our patient's OCD, she responded well to medical management and did not require neurosurgical intervention to improve. This concept of structural subcortical lesions resulting in OCD and successfully treated with standard psychiatric treatment, has been previously described in ischemic infarcts [6] and brain tumors [1].…”

“…Most specifically, bilateral caudate head lesions have resulted in OCD [5]. Unilateral structural lesions are less common but can be associated with OCD; etiologies such as ischemic strokes and tumors have been described [1,[6][7][8].…”

Comparing Effectiveness Between a Mobile App Program and Traditional Cognitive Behavior Therapy in Obsessive-Compulsive Disorder: Evaluation Study

“…Chen et al reported that patients with OCD showed decreased brain activity within the left medial prefrontal cortex, compared to healthy subjects [42]. In patients with obsessive and compulsive symptoms due to temporal lobe infarction, SSRI treatment would improve the obsessive and compulsive symptoms [43]. The parahippocampal gyrus is known to play a crucial role in the perception of emotion [44].…”