In a recently published case study, doctors describe exactly how a woman along with treatment-resistant depression was eventually diagnosed along with a mind tumor.
“Depressive symptoms could be the just expression of mind tumors,” Dr. Sophie Dautricourt of Centre Hospitalier Universitaire Caen, France, and colleagues write in BMJ Case Reports. “Thus, it is challenging to suspect a mind tumor as quickly as patients along with depression have actually a typical neurological examination.”
They illustrate this phenomena by outlining the case of a 54-year-old woman that had been depressed for 6 months. She was experiencing apathy, difficulties making decisions, sleep disorders, suicidal thoughts, and complications along with concentration and attention.
There was no personal or family history of mental illness, however she had recently gone through several stressful events. The antidepressant fluoxetine and the anti-anxiety medication bromazepam had no effect and were discontinued after 5 months.
Once the patient was offered a mind CT scan and MRI scan, it became clear she had several meningiomas, common tumors of the central nervous system, along with a giant meningioma in the left frontal lobe. These tumors are not usually cancerous, and affect the membranes that surround the mind and spinal cord. They can easily bring about erosion and thinning of the skull.
The left frontal lobe “is a spot known to have actually an essential role in the improvement of depression for patients along with tumors in the brain,” the experts write.
“Her meningiomatosis improved after surgery,” they add. “The depressive symptoms disappeared within one month. This case highlights the importance of recognizing signs of mind tumor in patients along with depression.”
The experts write that psychiatric symptoms such as depression, mania, hallucinations, anxiety disorders, and anorexia nervosa, also devoid of any kind of neurological signs, could be a authorize of a mind tumor, despite the fact that “it appears unrealistic to prescribe mind imaging in every patient along with a depressive syndrome.”
A study published in might 2016 investigated the fee of considerable psychiatric symptoms in patients along with meningiomas and discovered that they affect up to 35 percent of patients. Dr. Kalyan Bommakanti of Nizam’s Institute of Medical Sciences in Hyderabad, India, and colleagues additionally looked at the factors that motivate these psychiatric symptoms, and the effects of surgery.
They recruited 57 meningioma patients aged 15 and 65 years seen in the hospital in between 2006 and 2009. Psychiatric symptoms taken place a lot of frequently in the group along with meningiomas in the temporal location (60 percent), followed by the frontal location (46 percent).
Tumors located in the frontal cerebral lobe were associated along with a lot more serious depressive symptoms compared to tumors in the posterior mind region. Overall risk of psychiatric symptoms was a lot greater for patients along with bigger meningiomas very compared to smaller sized tumors.
Following surgery, none of the patients made brand-new psychiatric symptoms. Among those along with psychiatric symptoms, 45 percent forever recovered, 40 percent partly recovered, and 15 percent did not increase at all.
In the diary Clinical Neurology and Neurosurgery, they write, “Surgical excision of meningiomas ameliorates the psychiatric symptoms, either forever or partly, in the majority of patients.”
Commenting on her case study, Dautricourt says that the location of the tumor “points to an essential role in the improvement of depression for patients along with a mind tumor.” She explains, “Disruption of the frontolimbic connections appears to play a a lot more essential role compared to the frontal cortex lesions themselves, in the improvement of depressive mood states.”
She states, “Detecting a mind tumor in patients along with depression is a primary concern. Indeed, removing a mind tumor can easily mitigate mind damage, however might additionally reduce or alleviate depressive symptoms.”
Currently, there is no consensus on as quickly as to carry out mind imaging in patients along with depressive syndromes.
The group recommends mind imaging in cases along with some abnormalities in a neurological examination, or in the absence of neurological signs, as quickly as there is late onset of depressive syndrome (after 50 years of age); treatment-resistant depression; or apathy devoid of dysphoric manifestations or along with a low emotional response.
There is additionally some debate among experts over the demand for mind imaging as quickly as the patient has actually new-onset psychosis, new-onset mood or memory symptoms, brand-new or atypical psychiatric symptoms, and personality changes.
“In conclusion,” they write, “we recommend utilizing mind imaging for tracking these clinical particularities in patients along with depression. This approach can easily bring about an early diagnosis of mind tumors and, thus, increase the functional and essential prognosis of these patients.”
References
Dautricourt, S. et al. Meningiomatosis revealed by a serious depressive syndrome. BMJ Case Reports, 23 December 2015 doi:10.1136/bcr-2015-211909
BMJ
Bommakanti, K. et al. Pre-operative and post-operative psychiatric manifestations in patients along with supratentorial meningiomas. Clinical Neurology and Neurosurgery, 17 might 2016 doi: 10.1016/j.clineuro.2016.05.018