Citation

Elefante C, Brancati GE, Oragvelidze E, Lattanzi L, Maremmani I, Perugi G. J. Clin. Med. 2022; 11(23).

Copyright

(Copyright © 2022, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/jcm11237212

PMID

unavailable

Abstract

Endometriosis is a systemic medical condition characterized by endometrial tissue that is abnormally implanted in extrauterine sites, including the central nervous system. In this article, we reported the case of a patient with presumed cerebral endometriosis who was diagnosed with bipolar disorder and panic disorder and systematically reviewed the literature for previously reported neuropsychiatric symptoms in patients with cerebral and cerebellar endometriosis. The PubMed, Scopus, and Web of Science bibliographic databases were searched according to the PRISMA guidelines. Seven previous case reports were found and described. While neurological disturbances dominated the clinical picture in the cases retrieved from the literature, our patient represented the first case to show both neurological and psychiatric manifestations. Atypical features of bipolar disorder including chronic mood instability, mixed episodes, and excitatory interepisodic symptoms were highlighted. During the neuropsychological evaluation, a dysexecutive profile consistent with frontal lobe pathology was evidenced. We hypothesized that the course and features of the illness were largely influenced by the presence of documented brain lesions compatible with endometrial implants, especially in the frontal region. Accordingly, patients with endometriosis who exhibit neurological as well as mental symptoms should be investigated for cerebral lesions. © 2022 by the authors.

Language: en

Keywords

adult; human; social interaction; systematic review; female; Review; case report; bipolar disorder; insomnia; abdominal pain; depression; white matter; suicide attempt; hospitalization; mood disorder; neuroimaging; circadian rhythm; neuropsychiatry; mental disease; clinical article; hospital admission; clinical feature; fluoxetine; paroxetine; sertraline; venlafaxine; psychiatric department; headache; avoidance behavior; impulsiveness; middle aged; panic; lithium carbonate; mianserin; family history; hospital patient; benzodiazepine derivative; trazodone; follow up; irritability; valproic acid; neurologic disease; frontal lobe; lamotrigine; hypomania; duloxetine; escitalopram; agitation; asthenia; pregabalin; gestagen; menopause; menstrual cycle; mental instability; oxcarbazepine; separation anxiety; electroencephalography; brain region; iatrogenic disease; caudate nucleus; brain damage; medical history; mixed mania and depression; laparoscopy; dyspareunia; left hemisphere; dysmenorrhea; endometriosis; cyclothymia; right hemisphere; memantine; emotional incontinence; ovariectomy; lithium sulfate; endometrium tumor; gynecologist; x-ray computed tomography; uncus; pelvic pain; executive functions; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; behavioral disinhibition; brain lesions; cerebral endometriosis; excitatory interepisodic symptom; gonadorelin derivative; mood instability; multimodal imaging; T2 weighted imaging; total hysterectomy