Neurological symptoms in schizophrenia: A case report

Abstract

Introduction

Patients with epilepsy and schizophrenia could present atypical clinical presentations with neurological symptoms that are not frequently presented in schizophrenia.

Case Report

We report the case of a 41-year-old male who was diagnosed of schizophrenia and was admitted into a long-stay psychiatric unit. He started at 33 years old with a depressive disorder. After prescribing venlafaxine, symptoms did not remit and the patient started to present apathy, anhedony, impoverished speech, social isolation and blunted affect. Then, the patient started to present behavioral disturbances consisted in regressive behavior, aggressive behavior, inappropriate language, echolalia, sexual disinhibition, impulsivity, worsening of executive functions and soliloquies. A neurological study was made with CT scan and electroencephalography, and no evidences of neurological abnormalities were found. After that, clozapine was prescribed, with an improvement of some symptoms like apathy, anhedony and aggressive behavior, but persisting the impulsivity, regressive behavior, inappropriate language, sexual disinhibition and echolalia.

Discussion

Patients with schizophrenia and epilepsy could not respond appropriately to antipsychotic drugs. In this patient, the psychiatric symptoms more frequently seen in schizophrenia responded well to clozapine, but neurological symptoms did not improve with the standard treatment, causing a severe disability to the patient that was the main reason for his prolonged admission.

Conclusions

It is recommended to make a detailed neurological exploration in all psychiatric patients, in order to explore atypical symptoms and comorbidities that could reveal new diagnosis and therapeutic objectives.

Disclosure of interest

The authors have not supplied their declaration of competing interest.