Normal Pressure Hydrocephalus Presenting as Othello Syndrome: Case Presentation and Review of the Literature

Yusim, Anna; Anbarasan, Deepti; Bernstein, Carol; Boksay, István; Dulchin, Michael; Lindenmayer, Jean Pierre; Saavedra-Velez, Carlos; Shapiro, Maksim; Sadock, Benjamin J.

doi:10.1176/appi.ajp.2008.07111820

Cited by 31 publications

(23 citation statements)

References 36 publications

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“…NPH patients may develop symptoms with frontal dominance, such as personality changes; anxiety; depression; psychotic syndromes, like delusional states, hallucinations and aggressive states; obsessive compulsive disorder; Othello syndrome; shoplifting and mania 13,14,15,16 . Basal ganglia symptoms are exemplified by chorea 17 .…”

Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Oliveira

Rotta

et al. 2014

Arq. Neuro-Psiquiatr.

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Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment.Keywords: normal pressure hydrocephalus, psychiatry, symptoms. RESUMO A hidrocefalia de pressão normal (HPN) é caracterizada por distúrbios da marcha, demência e/ou incontinência urinária associada com dilatação do sistema ventricular e pressão de abertura do líquido cefalorraquidiano normal. Evidências científicas confirmam associação entre HPN e sintomas psiquiátricos. Foram selecionados 35 pacientes com hidrocefalia de pressão normal idiopática, de janeiro de 2010 a janeiro de 2012 em um hospital terciário brasileiro e realizada uma avaliação psiquiátrica formal para identificar transtornos psiquiátricos. Transtornos psiquiátricos foram detectados em 71% dos pacientes, principalmente depressão, ansiedade e síndromes psicóticas. Pacientes com HPN podem desenvolver sintomas com predomínio frontal, tais como mudanças de personalidade, ansiedade, depressão, síndromes psicóticas, transtorno obsessivo compulsivo, síndrome de Otelo, furtos e mania. Sintomas incomuns de HPN podem dificultar o diagnóstico precoce e o tratamento adequado.Palavras-chave: hidrocefalia de pressão normal, sintomas, psiquiatria.Normal pressure hydrocephalus (NPH) is a syndrome characterized by gait disturbance, dementia and urinary incontinence plus dilation of ventricular system due to disturbance of cerebrospinal fluid (CSF) circulation with normal CSF pressure 1,2,3,4,5,6 . Dilated ventricles theoretically impair perfusion in ventricular walls, generating hypoperfusional states especially in frontal lobes, basal ganglia and thalamus, thus resulting classic symptomatology 7 . NPH can present in two forms: primary (also known as idiopathic), when there are no causative disorders and secondary, where other disorders such as trauma, infection and hemorrhage are putative causes for hydrocephalus 1,2,3,4,5,6 . Idiopathic NPH (INPH) is associated with communicating hydrocephalus (as demonstrated by brain CT or MRI) and CSF pressure within normal range (7-24 cm H2O) 1,2,3,4,5,6 . With improvements in quality of life and subsequent increase in life expectancy, it is expected that a greater number of elderly individuals will suffe...

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Section: Discussionmentioning

confidence: 99%

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Oliveira

Rotta

et al. 2014

Arq. Neuro-Psiquiatr.

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“…Oliveira et al showed that up to 70% of patients with NPH may present neuropsychiatric symptoms, which may be from metabolic impairments in frontal lobe, basal ganglia and thalamus, all of which can be involved in pathophysiology of OS [1][2][3][4][5][6][7][8][9][10] .…”

Section: Discussionmentioning

confidence: 99%

“…Othello syndrome (OS) is a content-specific jealousy delusion characterized by fixed false belief that one's partner has been or is being unfaithful [5][6][7][8][9][10] . We report an unusual case of NPH associated with Othello-like syndrome [5][6][7][8][9][10] , and complete improvement of psychiatric symptoms after proper neurosurgical treatment.…”

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confidence: 99%

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Resolution of Othello-like syndrome following ventricular shunting in a post traumatic normal pressure hydrocephalus subject

Pinto¹,

Stump²,

Valiengo³

et al. 2016

Arch. Clin. Psychiatry (São Paulo)

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“…Personality changes, anxiety, depression, psychotic syndromes, delusional disorder, agitation, mania, kleptomania, and OCD were observed in case reports published so far (6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 97%

Obsessive compulsive symptoms presented during the course of chronic normal pressure hydrocephalus: a case report

Açar¹,

Ozelci²,

Erol³

2018

Dusunen Adam

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Obsessive compulsive symptoms presented during the course of chronic normal pressure hydrocephalus: a case report Normal pressure hydrocephalus (NPH) is usually presented with psychiatric symptoms. Obsessive compulsive disorder (OCD) and NPH comorbidity is rare and there are only few case reports on this topic.Our case who had chronic NPH secondary to intracranial hemorrhage presented with obsessive compulsive (OC) symptoms while he was treated at neurology inpatient clinic for epilepsy. He benefited from sertraline and quetiapine treatment. Our case is thought to be the first case in terms of comorbidity of chronic NPH and OC symptoms in Turkey.

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Normal Pressure Hydrocephalus Presenting as Othello Syndrome: Case Presentation and Review of the Literature

Cited by 31 publications

References 36 publications

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus

Resolution of Othello-like syndrome following ventricular shunting in a post traumatic normal pressure hydrocephalus subject

Obsessive compulsive symptoms presented during the course of chronic normal pressure hydrocephalus: a case report

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