title: [Mineralization of the basal ganglia as the supposed cause of poor tolerance of zuclopenthixol in a patient with long-term untreated paranoid schizophrenia].
abstract: Formations described as intracranial calcifications can appear in the course of diseases of the central nervous system, other systems and organs (e.g. endocrine), but also as a disorder of idiopathic character. They are frequently located in subcortical nuclei and usually constitute an incidental finding. This report presents the case of a patient suffering from paranoid schizophrenia for approximately 40 years, who did not agree to any treatment and was hospitalized against her will because she was the threat to the lives of others. She was treated with zuklopentixol resulting in positive symptoms reduction and considerable improvement in social functioning. Unfortunately neurological symptoms appeared: bradykinesis, rigidity--of the type of the lead pipe, balance, posture and gait abnormalities, disturbances in precise hands movements, double-sided Rossolimo's sign, plantar reflex without the participation of the big toe on the left. Neuroimaging studies have demonstrated changes in the form of lenticular nuclei calcification and reduction of signal intensity in posterior parts of both putamens. Neurological symptoms decreased significantly after switching to atypical neuroleptic (olanzapine), and the patient did not require any additional treatment. Mineralization of the basal ganglia can often be associated with psychiatric disorders and it shouldn't be neglected because it can require modification of pharmacotherapy or additional neurological treatment.
authors.forename: Hubert M
authors.initials: HM
authors.lastname: Wichowicz
authors.forename: Alina
authors.initials: A
authors.lastname: Wilkowska
authors.forename: Zyta
authors.initials: Z
authors.lastname: Banecka-Majkutewicz
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kummer
authors.forename: Joanna
authors.initials: J
authors.lastname: Konarzewska
authors.forename: Alicja
authors.initials: A
authors.lastname: Raczak
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001480:Basal Ganglia Diseases / Q000150:complications* / Q000175:diagnosis*; D001569:Benzodiazepines / Q000627:therapeutic use; D002114:Calcinosis / Q000150:complications* / Q000175:diagnosis*; D003006:Clopenthixol / Q000627:therapeutic use; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D000077152:Olanzapine; D012008:Recurrence; D012563:Schizophrenia, Paranoid / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome; D016312:Treatment Refusal
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D003006:Clopenthixol; D000077152:Olanzapine