Hoofbeats and zebras: neurodegenerative disorder presenting as a "first episode" of psychosis

Abstract

Neurodegenerative disorders can include diverse neuropsychiatric symptoms. Here we present a case referred to a "first-episode" psychosis clinic with socio-occupational decline, auditory hallucinations and paranoid ideation who subsequently exhibited a rapid, severe cognitive and behavioral decline. The brain magnetic resonance imaging findings of the patient have shown a progressive cortical atrophy prominent in the frontal lobes due to a neurodegenerative disorder.

Copyright © 2011 Elsevier Inc. All rights reserved.

Figures

Figure 1

A, B. An interval of 15 months between two imaging studies (A; the first repeat MRI, B; the second repeat MRI) showed a significant worsening in the cerebral volume loss prominent in the frontal lobes.