Jealousy's stroke: Othello syndrome following a percheron artery infarct.

IF 0.6 4区 医学 Q4 CLINICAL NEUROLOGY
Neurocase Pub Date : 2024-10-01 Epub Date: 2024-12-05 DOI:10.1080/13554794.2024.2436159
Ghita Hjiej, Maha Abdellaoui, Hajar Khattab, Kamal Haddouali, Salma Bellakhdar, Bouchera El Moutawakil, Mohammed Abdoh Rafai, Hicham El Otmani
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引用次数: 0

Abstract

Introduction: Othello syndrome is a psychosis with delusions of infidelity, where the patient harbors a persistent, unfounded belief - a "delusion" - that their partner is being unfaithful. This condition can manifest in certain psychiatric conditions and neurological disorders, such as neurodegenerative diseases, as parkinson's disease treatment side effects, or occasionally after a stroke.

Case: We report a rare case of a 50-year-old woman, with no previous psychiatric history, who developed a delusion of infidelity, leading to verbal and physical aggressions with bladed weapons, days after experiencing a bi-thalamic infarct due to the occlusion of the Percheron artery.

Discussion: Psychosis is the third most common psychiatric symptom post-stroke, with delusional disorders being the most prevalent type. Within this category, delusional jealousy is the second most common subtype, following persecutory delusions. Although no specific brain lesions are exclusively responsible for jealousy delusions, lesions in various regions, particularly in the right hemisphere, have been implicated. Thalamic strokes disrupt the frontal-subcortical-thalamic circuitry, crucial for executive functions, and the dorsomedial nuclei, leading to alterations in limbic circuitry and emotional regulation. These damages can result in significant impairments in impulse control and judgment, manifesting as behavioral disorders due to a flawed interpretation of a partner's actions as infidelity. In this case, our patient experienced a bi-thalamic infarct predominantly on the right side.

Conclusion: Othello syndrome represents a challenging post-stroke complication, highlighting the intricate relationship between neurological damage and psychiatric manifestations. Recognizing and promptly addressing this syndrome is crucial, given its potential for dangerous outcomes.

嫉妒中风:动脉梗塞后的奥赛罗综合症。
简介:奥赛罗综合症是一种伴有不忠妄想的精神病,患者怀着一种持久的、毫无根据的信念——一种“错觉”——认为他们的伴侣不忠。这种情况可表现为某些精神疾病和神经系统疾病,如神经退行性疾病,如帕金森病治疗的副作用,或偶尔在中风后出现。病例:我们报告一个罕见的病例,一位50岁的女性,之前没有精神病史,在经历了由于Percheron动脉闭塞导致的双丘脑梗死几天后,出现了不忠妄想,导致言语和肢体攻击。讨论:精神病是继中风之后第三大最常见的精神症状,妄想障碍是最普遍的类型。在这一类别中,妄想嫉妒是第二常见的亚型,仅次于受迫害妄想。虽然没有特定的大脑损伤是嫉妒妄想的唯一原因,但不同区域的损伤,特别是右半球的损伤,都有牵连。丘脑中风破坏了对执行功能至关重要的额叶-皮质下-丘脑回路和背内侧核,导致边缘回路和情绪调节的改变。这些损害会导致冲动控制和判断的严重损害,表现为行为障碍,因为错误地将伴侣的行为解释为不忠。在这个病例中,我们的病人经历了双丘脑梗死,主要发生在右侧。结论:奥赛罗综合征是一种具有挑战性的卒中后并发症,突出了神经损伤与精神表现之间的复杂关系。鉴于其潜在的危险后果,认识并及时处理这一综合征至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurocase
Neurocase 医学-精神病学
CiteScore
1.40
自引率
12.50%
发文量
70
审稿时长
6-12 weeks
期刊介绍: Neurocase is a rapid response journal of case studies and innovative group studies in neuropsychology, neuropsychiatry and behavioral neurology that speak to the neural basis of cognition. Four types of manuscript are considered for publication: single case investigations that bear directly on issues of relevance to theoretical issues or brain-behavior relationships; group studies of subjects with brain dysfunction that address issues relevant to the understanding of human cognition; reviews of important topics in the domains of neuropsychology, neuropsychiatry and behavioral neurology; and brief reports (up to 2500 words) that replicate previous reports dealing with issues of considerable significance. Of particular interest are investigations that include precise anatomical localization of lesions or neural activity via imaging or other techniques, as well as studies of patients with neurodegenerative diseases, since these diseases are becoming more common as our population ages. Topic reviews are included in most issues.
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