title: Peduncular psychosis.
abstract: Psychotic symptoms are rarely documented in association with cortex-sparing central nervous system (CNS) lesions limited to the midbrain. We present the case of a 15-year-old boy with hereditary and environmental risk factors for psychiatric illness, as well as a history of midbrain pilocytic astrocytoma treated with chemotherapy and focused radiation, who presented with non-epileptic seizures, hyper-religiosity and frank psychosis. The space-occupying midbrain lesion has been radiographically stable while the patient has decompensated psychiatrically. Differential aetiology for the patient's psychiatric decompensation is discussed, including psychosis secondary to a lesion of the midbrain. Literature linking midbrain lesions to psychotic features, such as in peduncular hallucinosis, is briefly reviewed. This case suggests that a midbrain lesion in a susceptible patient may contribute to psychosis.
authors: Yale University School of Medicine, New Haven, Connecticut, USA.
authors: John Paul
authors: http://orcid.org/0000-0002-8025-1525
authors: JP
authors: Andrews
authors: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Joseph
authors: J
authors: Taylor
authors: Yale University School of Medicine, Child Study Center, New Haven, Connecticut, USA.
authors: David
authors: D
authors: Saunders
authors: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA Yale University School of Medicine, Child Study Center, New Haven, Connecticut, USA.
authors: Zheala
authors: Z
authors: Qayyum
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000523:psychology* / Q000628:therapy; D020295:Brain Stem Neoplasms / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000209:etiology*