Post-stroke subakut evrede görülen progresif atipik psikiyatrik belirtiler ve parkinsonizm

İnmenin, hastaların psikolojik ve fiziksel sağlığı üzerinde önemli etkisi vardır. İnme sonrası erken dönemde yaklaşık %1-4 oranında hareket bozukluğu görülür. İnme sonrası genellikle depresyon görülürken, erken subakut dönemde nadiren psikoz benzeri atipik psikiyatrik belirtiler olabileceği belirtilmekteydi. Burada iskemik stroke sonrası ikinci haftada atipik psikiyatrik bulgular, üçüncü haftada parkinsonizm semptomlarının başlayarak progresif seyir gösterdiği bir vakayı sunmayı amaçladık.

Parkinsonism and progressive atypical psychiatric symptoms in the post-stroke subacute period

Stroke has a significant impact on the psychological and physical health of patients. Approximately 1%–4% of patients, movement disorders develop in the early post-stroke period. While chorea appears within hours of a stroke, post-stroke dystonia and tremor may develop after several months. Depression is generally observed in the post-stroke period; however, reports of atypical psychiatric symptoms, such as psychosis, in the early subacute-stroke period are rare. Herein, we demonstrate the case of a patient in whom parkinsonism symptoms and atypical psychiatric findings were found, which progressed to 3 and 2 weeks, respectively, after ischemic stroke.

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  • Adıgüzel, A., Öztürk, Ü. & Altinayar, S. (2020). Predicting the risk of dyskinesia development in parkinson’s disease. Turkish Journal of Geriatrics, 23(2), 224-229.
  • Bonelli, R.M. & Cummings, J.L. (2022). Frontal-subcortical circuitry and behavior. Dialogues in Clinical Neuroscience, 9(2), 141-151.
  • Çıplak, S., Adıgüzel, A. & Akalın, Y. (2022). The effect of intravenous thrombolytic and intraarterial interventional procedures on acute stroke: First-year clinical experience of a stroke center in eastern anatolia. Medicine, 11(1), 15-9.
  • Droś, J., Kowalska, K., Pasińska, P., Szyper-Maciejowska, A., Gorzkowska, A. & Klimkowicz-Mrowiec, A. (2020).
  • Delirium post-stroke—influence on post-stroke dementia (research study—part of the propolis study). Journal of Clinical Medicine, 9(7), 2165.
  • Ferreira, M.d.C., Machado, C., Santos, B. & Machado, Á. (2017). Post-stroke psychosis: how long should we treat? Trends in Psychiatry and Psychotherapy, 39, 144-146.
  • Ghika-Schmid, F., Ghika, J., Regli, F. & Bogousslavsky, J. (1997). Hyperkinetic movement disorders during and after acute stroke: the Lausanne Stroke Registry. Journal of the Neurological Sciences, 146(2), 109-116.
  • Handley, A., Medcalf, P., Hellier, K. & Dutta, D. (2009). Movement disorders after stroke. Age and Ageing, 38(3), 260-266.
  • Investigators, W.M.P.P. (1988). The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. Journal of Clinical Epidemiology, 41(2), 105-114.
  • Kumral, E., Evyapan, D. & Balkir, K. (1999). Acute caudate vascular lesions. Stroke, 30(1), 100-108.
  • Lo Buono, V., Corallo, F., Allone, C., Bonanno, L., Sessa, E., Todaro, A.,….& Marino, S. (2019). Thought disorder in atypical schizophrenia-like psychosis after stroke: analysis of clinical cases. Neurocase, 25(3-4), 130-132.
  • Rhee, J.Y., Colman, M.A., Mendu, M., Shah, S.J., Fox, M.D., Rost, N.S. & Kimchi, E.Y. (2022). Associations between stroke localization and delirium: a systematic review and meta-analysis. Journal of Stroke and Cerebrovascular Diseases, 31(3), 106270.
  • Srivastava, S., Agarwal, M.P. & Gautam, A. (2017). Post stroke psychosis following lesions in basal ganglion. Journal of Clinical and Diagnostic Research: JCDR, 11(5), VD01.
  • Suri, R., Rodriguez-Porcel, F., Donohue, K., Jesse, E., Lovera, L., Dwivedi, A.K. & Espay, A.J. (2018). Post-stroke movement disorders: the clinical, neuroanatomic, and demographic portrait of 284 published cases. Journal of Stroke and Cerebrovascular Diseases, 27(9), 2388-2397.
  • Wagner, S.J. & Begaz, T. (2008). Basal ganglion stroke presenting as subtle behavioural change. Emergency Medicine Journal, 25(7), 459-459.