Verhaltensauffälligkeiten und Persönlichkeitsveränderung bei zerebraler Amyloidangiopathie

Zusammenfassung

Anliegen: Die zerebrale Amyloidangiopathie (ZAA) gehört zu den Amyloidosen und wird meist durch spontane intrazerebrale Blutungen symptomatisch. Obwohl die ZAA eine neurologische Erkrankung ist, können psychiatrische Symptome auftreten.

Methode: Anhand eines Fallberichts soll dieser Zusammenhang illustriert werden.

Ergebnisse: Wir berichten über eine 54-jährige Patientin mit wahrscheinlicher ZAA und nur geringgradig eingeschränkten kognitiven Funktionen, welche im Kontext der ZAA Verhaltensstörungen und eine Wesensänderung entwickelt hatte.

Schlussfolgerungen: Die ZAA kann mit psychiatrischen Symptomen assoziiert sein. Bei älteren Patienten mit Verhaltensauffälligkeiten oder Persönlichkeitsveränderungen sollte an die ZAA gedacht und eine zerebrale Bildgebung sowie eine Untersuchung des Liquors veranlasst werden.

Abstract

Objective: Cerebral amyloid angiopathy (CAA) belongs to the group of amyloidoses that are characterized by the deposition of insoluble and tissue-damaging amyloid proteins. Spontaneous intracerebral hemorrhage is the common clinical presentation of CAA resulting from the degenerative effect of beta amyloid on the cerebral vascular system. Though CAA is rather a neurological disease psychiatric symptoms can occur and even dominate the clinical picture.

Methods: A case report is presented in order to illustrate the association between CAA and psychiatric symptoms.

Results: We report the case of a 54-year-old female patient with radiologic references to a probable CAA and mild cognitive impairment who developed behavioural difficulties and personality change that necessitated a psychiatric treatment. Psychiatric symptoms were most likely due to CAA.

Conclusions: CAA can be associated with psychiatric symptoms and hence should be considered in the treatment of elderly patients with behavioural problems or personality changes. Diagnostic neuroimaging and examination of cerebrospinal fluid is recommended.

Schlüsselwörter

Amyloidose - mild cognitive impairment - organische psychische Störung - Verhaltensauffälligkeiten - Wesensänderung

Keywords

amyloidosis - mild cognitive impairment - behavioural disturbances - mental disorder due to a medical condition - organic personality disorder

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