Using of methylphenidate and risperidone in a case with Joubert's syndrome with comorbid disruptive behavior disorders

Joubert syndrome (JS) is a rare disorder characterized by a peculiar mid-brain-cerebral malformation and is known molar tooth sign (MTS)) Posterior interpedincular fossa’s depth increases, superior cerebellar peduncles thicken and vermis is hipoplastic in this syndrome. Cerebellar disorders; can cause many psychiatric disorders, including schizophrenia, bipolar disorder, depression, anxiety and attention deficit hyperactivity disorders. Many studies have shown that changes in the cerebellum in ADHD. In fact, some studies report that there is a relationship between ADHD severity with cerebellum volume and posterior fossa. ın this case report we aimed to discuss etiological mechanisms and treatment of mental retardation, ADHD and conduct disorder in joubert sydrome.

Yıkıcı davranım bozukluklarının eşlik ettiği Joubert sendromlu bir olguda metilfenidat ve risperidon kullanımı

Joubert sendromu molar diş görünümü ile karakterize nadir bir orta beyin-beyin malformasyonu bozukluğudur. Posterior interpedinküler fossa derinliğinde artma, süperior serebellar pedinküllerde kalınlaşma ve vermis hipoplazisi bu sendromda görülen bulgulardır. Serebeller bozukluklar şiozfreni, bipolar bozukluk, depresyon, anksiyete, dikkat eksikliği hiperaktivite bozukluğu (DEHB) gibi birçok psikiyatrik bozukluğa neden olabilmektedir. Bir çok çalışmada DEHB'nda serebellumda değişiklikler gösterilmiştir. DEHB ile serbellum ve posterior fossa volumleri arasında ilişki gösteren çalışmalar da mevcuttur. Bu olguda Joubert sendromunda DEHB, davranım bozukluğu ve mental retardasyon etyolojik mekanizmaları ve tedavileri açısından tartışılması amaçlanmıştır.

Kaynakça

Pringsheim T, Heisch L, Gardner D, Gorman DA. The pharmacological management of oppositional behaviour,conduct problems, and aggression in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder: a systematic review and metaanalysis. Part 2: antipsychotics and traditional mood stabilizers. Can J Psychiatr 2015;60:52-61.

Chou TL, Chia S, Shang CY, Gau SS. Differential therapeutic effects of 12-week treatment of atomoxetine and methylphenidate on drug-naive children with attention deficit/hyperactivity disorder: a counting Stroop functional MRI study. Eur Neuropsychopharmacol 2015;25:2300-2310.

Gontkovsky ST, Nevels R, McDonald NB, Winkelmann MH. Decreased serum glucose levels after initiation of methylphenidate in a patient status post-cerebellar tumour resection: a potential interaction with glipizide. Clin Drug Invest 2007;27:719-725.

Cubillo A, Halari R, Smith A, Taylor E, Rubia K. A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. Cortex 2012;48:194-215.

Faraone S, Biederman J. Pathophysiology of attention deficit hyperactivity disorder. Neuropsychopharmacology: The Fifth Generation of Progress (Davis KL, Charney D, Coyle JT, Nemeroff C, eds). Philadelphia: Lippincott Williams & Wilkins, 2002:577-596.

Friedman LA, Rapoport JL. Brain development in ADHD. Curr Opin Neurobiol 2015;30:106-111.

Buonaguro E.F, Cimmarosa S, Bartolomeis A.D. Dandy-Walker Syndrome with psychotic symptoms: a case report. Riv Psichiatr 2014;49:100-102.

Maria BL., Quisling RG, Rosainz LC, et al. Molar tooth sign in Joubert syndrome: clinical, radiologic, and pathologic significance. J Child Neurol;1999:14:368-376.

Steinlin M. Cerebellar disorders in childhood: cognitive problems. Cerebellum 2008;7:607-610.

Phillips JR, Hewedi DH, Eissa AM, Moustafa AA. The cerebellum and psychiatric disorders. Front Public Health 2015;3:66.

Stoodley CJ. The cerebellum and neurodevelopmental disorders. Cerebellum 2016;15:34-37.

Can SS, Uğurlu GK, Çakmak S. Dandy Walker variant and bipolar I disorder with graphomania. Psychiatr Invest 2014;11:336-339.

Fennell EB, Gitten JC, Dede DE, Maria BL. Cognition, behavior, and development in Joubert syndrome. J child neurol 1999;14:592-596.

Farmer JE, Deidrick KM, Gitten JC, Maria BL. Parenting stress and its relationship to the behavior of children with Joubert syndrome. J child neurol 2006;21:163-167.

Dallapiccola VEB, Bertini. E. Joubert syndrome and related disorders. Handbook of clinical neurology 2012;113:1879-1888.

Kaynak Göster