Citation

Nagashima T, Miyamoto T, Morikawa M, Negoro H, Kishimoto T. Journal of Nara Medical Association 2006; 57(2-3): 67-72.

Copyright

(Copyright © 2006)

DOI

unavailable

PMID

unavailable

Abstract

A 17-year-old female with adjustment disorder repeated suicide attempts (self poisoning and cutting) several times due to unstable mental states such as impulsive behaviors. She developed neuroleptic malignant syndrome (NMS) after taking large amounts of drugs (analgesics and antipyretics) and was admitted to the emergency center at Nara Medical University. She was treated intensively, but cerebellar ataxia such as intention tremor and vertical nystagmus occurred subsequently after physical improvement. She understood spoken words, but did not speak any words herself. Some mental influences on her symptoms were suspected and she was moved to a psychiatric ward. We speculated that exposure to abnormal high temperature damaged Purkinje cells in the cerebellum and started to administer tartaric acid protirelin intravenously. Several days later explosive speech appeared and three months later atrophic changes were found in the cerebellar hemisphere by brain MRI. Her cerebellar ataxia was gradually improved by medication and physical therapy, and control of her impulsiveness was also improved by intrafamilial adjustment.

Language: ja

Keywords

adolescent; human; mental health; female; case report; Overdose; suicide attempt; article; analgesic agent; clinical feature; psychiatric department; impulsiveness; nuclear magnetic resonance imaging; diazepam; protirelin; physiotherapy; dose response; adjustment disorder; neuroleptic malignant syndrome; Neuroleptic malignant syndrome; cell damage; antipyretic agent; Atrophy; cerebellar ataxia; Cerebellar ataxia; Purkinje cell; tartaric acid