Psychotic disorder of organic etiology, in the context of sarcoidosis. A case report

• Published in: European psychiatry Vol. 41; no. S1; pp. S836 - S837
• Main Authors: Sánchez Blanco, L., Juncal Ruíz, M., Pardo de Santayana Jenaro, G., Gómez Revuelta, M., Landera Rodríguez, R., Porta Olivares, O., López García, E., Pérez Herrera, M., Núñez Morales, N.I.
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.04.2017
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2017.01.1647

Neurosarcoidosis is an uncommon cause of psychosis. It courses with an affectation of the brain, the spinal cord and other areas of the nervous system. It associates both neurological and psychiatric symptoms: cranial mononeuropathy, myelopathy or radiculopathy meningitis, neuroendocrine dysfunction, dementia, delusions, hallucinations. To review in Pub-Med about neuropychiatric manifestarions of neurosarcoidosis. We describe the case of 60-year-old woman diagnosed with long evolution schizoaffective disorder with a recent decompensation in the context of a stressful situation. As somatic background to highlight: cognitive impairment (encephalic bilateral and symmetrical frontal atrophy in cranial magnetic resonance) and a probable sarcoidosis with hilia and mediastinal lymph nodes without histologic confirmation. She was hospitalized at the acute care unit because of a descompensation of her schizoaffective disorder. The patient was distressed, with delirious speech, sensoperceptive hallucinations, hypothymia and weigth loss. Firstly we evaluate the lack of clinical improvement with an anti-psychotic drug in previous hospitalizations. For that reason, we thought in organic mental disorder as an alternative diagnosis. We started treatment with corticosteroids in spite of we did not observe a decompensation of sarcoidosis. In a few days it was remarked a clinical improvement and remission of the delusional and affective clinic. It is needed to complete the study and continue the monitoring of the patient to see the evolution and drug response. The diagnosis of neurosarcoidosis should be kept in mind for patients with both neurologic and psychiatric symptoms.