Neuropsychiatric disorders, myoclonus, and dystonia in calcification of basal ganglia pathways.
Two cases of basal ganglia calcification involving the globus pallidus are presented. Both patients had cognitive dysfunction, temporal lobe-like symptoms (including amnestic state, perceptual distortions, or complex visual hallucinations), and myoclonus. Patient 1 manifested depression, auditory hallucinations, anxiety, paranoia, and postural tremor; patient 2 manifested multifocal dystonia with dystonic tremor. These cases supplement other reports of psychotic features and dementia associated with pallidal pathology. Additionally, the phenomena encountered in these cases are considered in light of recent advances in our understanding of basal ganglia functional pathways. These cases afford a potential pathophysiological window to the possible role of the globus pallidus in these neuropsychiatric conditions. In concert with other recent findings, these cases suggest specific pathway involvement in hallucinations, paranoia, depression, myoclonus, and dystonia. Further research will indicate if these pathways play a role in schizophrenia, mood disorders, and anxiety disorders.
Lauterbach
E C
EC
Department of Psychiatry, Mercer University School of Medicine, Macon, Georgia 31207.
Spears
T E
TE
Prewett
M J
MJ
Price
S T
ST
Jackson
J G
JG
Kirsh
A D
AD
D000328:Adult; D001480:Basal Ganglia Diseases / Q000150:complications*; D002114:Calcinosis / Q000150:complications* / Q000473:pathology; D003072:Cognition Disorders / Q000209:etiology; D003704:Dementia / Q000209:etiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology*; D004421:Dystonia / Q000209:etiology*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000473:pathology; D006212:Hallucinations / Q000209:etiology; D006801:Humans; D008297:Male; D009207:Myoclonus / Q000209:etiology*; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D014057:Tomography, X-Ray Computed