Brian Zeman
Ryde and Royal North Shore Hospitals, Australia
Title: Case report- Psychosis due to iatrogenic causes, cerebral palsy or spontaneous
Biography
Biography: Brian Zeman
Abstract
Ms M is a 42 year old woman with cerebral palsy affecting her mobility and speech. She was independent in the community and working. She also had unrelated chronic asthma and after an exacerbation was prescribed prednisone. She then developed psychosis gradually over four weeks. The prednisone was stopped and she was prescribed an antipsychotic. She then developed extrapyramidal reaction causing torticollis and limb spasm. The antipyschotic was ceased and she was prescribed Benztropine. She did not improve and remained hospitalised. She had Botulinum toxin injections to the neck and later leg as well as extensive physiotherapy with gradual improvement. There was some improvement but not to previous mobility levels. About two monhts later, she again gradually developed psychosis with auditory and visual hallucinations. She had extensive investigations but there were no obvious causes. Management of the psychosis with medications has been difficult and she required admission to psychiatric unit to have these monitored. Was the psychosis due to triggered by prednisone, related to her CP and immature brain or was it spontaneous and unrelated?