Menstruation Related Recurrent Psychosis: A Case Report Menstrüasyon İlişkili Rekürren Psikoz: Olgu sunumu

Year 2019, Volume: 7 Issue: Ek - IRUPEC 2019 Kongresi Tam Metin Bildirileri, 191 - 194, 10.12.2019

Kezban Öztürk Gül Yücel , Hüseyin Çaksen

Abstract

Menstruation related recurrent psychosis (MRRP) is a rare disease. Its etiology is still unclear. The hormonal changes of the menstrual cycle may be contributing to the pathophysiology of psychiatric conditions.
Case Report: A 16-year-old female patient was referred to our pediatric neurology outpatient clinic for further examination. About 2 years ago, she suddenly complained of inability to speak, inability to stay alone, forgetfulness, refusing to eat and numbness involving her left face, and had no seizures. Her psychiatric complaints lasted for a week per month and resolved spontaneously. For the last two years, she had history of multiple admissions for brief delusional episodes to another hospital. In the period following the onset of complaints, her family noticed that the child’s complaints occur during her menstrual cycle. After each menstrual period, her symptoms disappear completely and don’t require treatment with anti-psychotic medication. There is no history of trauma, fever or toxic exposure. There is no family or personal history of any psychiatric or neurologic illness. She was hospitalized at another center and examined for infectious, metabolic, autoimmune and toxic causes. All test results were normal. She was diagnosed with MRRP and started on quetiapine. On the third day, she exhibited a significant improvement in symptoms, and we stopped her medication. If the patient had similar complaints in the next episode, the same treatment was planned. She has been regularly followed-up for four months and did not yet have a heavy attack requiring antipsychotics.
Conclusion: We present a patient with menstruation induced psychosis, due to its rarity. It is important to publish such cases in order to determine the actual incidence. Neurological examination of patients presenting with psychiatric symptoms is important but the relationship between the findings and menstrual cycle and history of spontaneous improvement after the period should be questioned.

Keywords

Menstruation, recurrent

References

• References 1 Griswold KS, Del Regno PA, Berger RC. Recognition and Differential Diagnosis of Psychosis in Primary Care. Am Fam Physician 2015 Jun; 91(12):856-63. 2 Brockıngton I. Menstrual psychosis. World Psychiatry 2005 Feb; 4(1): 9–17. 3 Freudenreich O. Differential diagnosis of psychotic symptoms: medical “mimics”. Psychiatr Times 2010; 27(12):56-61. 4 Krafft-Ebing R. Psychosis Menstrualis. Eine klinisch-forensische Studie. Stuttgart: Enke, 1902. 5 Stein D, Hanukoglu A, Blank S, Elizur A. Cyclic psychosis associated with the menstrual cycle. Br J Psychiatry 1993; 163:824-28. 6 Brockington IF. Menstrual psychosis: a bipolar disorder with a link to the hypothalamus. Current psychiatry reports 2011; 13:193-7. 7 Berlin FS, Bergey GK, Money J. Priodic psychosis of puberty: a case report. Am J Psychiatry 1982; 139:119-20. 8 Levenson JL. Psychosis in the medically ill. Primary Psychiatry 2005;12(8):16-18. 9 Corrêa BB, Xavier M, Guimarães J. Association of Huntington's disease and schizophrenia-like psychosis in a Huntington's disease pedigree. Clin Pract Epidemiol Ment Health 2006; 2:1. 10 Hopkins SA, Moodley KK, Chan D. Autoimmune limbic encephalitis presenting as relapsing psychosis. BMJ Case Rep 2013 Aug 30;2013.