Première décompensation psychotique sur gliome chez une patiente de 17 ans

Abstract

This case study aims to discuss the differential diagnosis of a 17-year-old female patient who, on an initial visit to the ER, was experiencing visual hallucinations. The patient was accompanied by her parents who explained that their daughter had exhibited major anxiety and paranoid ideas that had been evolving for several weeks. The patient reported peculiar visual and auditory hallucinations. A hallucination is a sensory perception in the absence of a detectable stimulus, which may affect one or more of the senses. Hallucinations are more frequent during childhood than in adolescence. Those occurring during childhood are more likely to be transient, only rarely associated with an underlying psychopathological process. Psychopathology is more prevalent when hallucinations occur in late adolescence. The analysis of risk and protective factors includes a global and multi-disciplinary assessment. The teenager had been treated for epilepsy since childhood, but had been experiencing an increase in major anxiety and paranoia for several weeks. A work-up for initial psychotic decompensation revealed an unusual presentation of a grade II ganglioglioma. The purpose of this clinical case study is to emphasize the importance of performing a somatic evaluation before considering the psychiatric hypothesis when confronted by a first hallucinatory presentation in a child or adolescent.