Open AccessLate-onset schizophrenia with isolated cavum vergae: Case report and literature review
Author(s) -
Rashmin Achalia,
Bhople Ks,
Pankaj Ahire,
Chittaranjan Andrade
Publication year - 2014
Publication title -
indian journal of psychiatry/indian journal of psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.485
H-Index - 34
eISSN - 1998-3794
pISSN - 0019-5545
DOI - 10.4103/0019-5545.146533
Subject(s) - psychosis , schizophreniform disorder , context (archaeology) , psychopathology , risperidone , psychiatry , schizophrenia (object oriented programming) , psychology , quetiapine , pediatrics , medicine , schizoaffective disorder , paleontology , biology
Cavum septum pellucidum (CSP) and cavum vergae (CV) have separately and together been associated with an increased risk of neurodevelopmental disorders and psychosis; however, there is little literature on the psychopathological significance of isolated CV, and no previous report of isolated CV in late-onset psychosis. We describe an 80-year-old woman who presented with a 1-month history of psychotic symptoms qualifying for a diagnosis of schizophreniform disorder. Physical (including neurological) examination, bedside cognitive testing, and laboratory investigations were all within normal limits. A magnetic resonance imaging scan of the brain revealed an insignificant CSP with prominent CV. The patient showed almost complete recovery from psychosis after 4-6 weeks of treatment with quetiapine (200 mg/day). She maintained improvement with this medication at an 18-month follow-up; medication taper was associated with re-emergence of hallucinations. We briefly discuss CSP and CV in the context of vulnerability to psychosis. We examine whether isolated CV is a benign and incidental finding versus a biological risk factor for neuropsychiatric illness. We suggest specific studies to resolve the uncertainty.