The 57-Year-old can no longer come alone to the emergency room, members bring him. All his life the man was mentally healthy, then he suddenly developed a depressive Phase. In the past few weeks he has lost around four kilos. The self-care he has largely given up, at night, he can’t hold his urine.
After his arrival in the Belgian clinic, the Doctors watch, as the man slumped down, sitting in a wheelchair. It takes only sparse contact with Eyes, most of the time he stares into the Nothing. His face is expressionless.
To questions the man answers delayed, usually he struggles, just a few words. Then he speaks of “foolish thoughts” or repeating the same, hopeless records. “It will never be better,” he says. “I’m not going to make it out of there.” Also the statements of the Doctors, the man repeated, without that it makes sense to report Anouchka Franssen and Pascal Sienaert of the University hospital in Leuven, in the journal “BMJ Case Reports”.
At the same time, the 57-exudes a great anxiety out of the Year. He commutes to the lower jaw, strums with his fingers, his feet tapping on the floor. When the Doctors ask him to get up, staggers him. The night before the arrival in the hospital, the Patient fell three times. His Problem: He tightens his muscles so much that you stiffen. Such a Rigid is typical of mental illness, but may also occur in inflammation of the brain.
Treatment in psychiatry
The overall picture of the patient for the physician sense. The man suffers from your point of view in a depressive Phase, with a catatonia, the term describes conditions with a mixture of movement disorders and arousal. Among the typical consequences of the rigid muscles, the Repeating of statements, the lack of mobility and the constant Repeating of the same sentences. Also, the incontinence fits the diagnosis.
In psychiatry, the Doctors begin to treat the man. Four times of the day, he receives a milligram of Lorazepam. The benzodiazepine combines with the so-called Gaba receptors in the brain that have a calming effect. In this way, the Central tensions, Fears, triggers and promotes sleep. Also can relax muscles of the Mediterranean.
Therapy, the man is physically a little better. For over feelings of Worry, loneliness and fear of death overwhelm him, however. Within a few days his behavior is changing extremely, he increasingly loses inhibitions, acts, sexually, sudden aggressive outbursts and begins to discuss endlessly about rules and regulations on the hospital station. In addition, he sees double.
The Doctors do a series of blood tests looking for viruses, sexually transmitted diseases, and traces of a possible inflammation of the Brain. However, all the values are normal. In neurological test, the Patient refuses to cooperate. After the physicians have mobilized his right Arm, in order to examine the tense muscles, he continues the motion over and over again. It looks as if he had lost control of it.
What is rampant in the head of the man?
In further Tests, the Doctors of the electrodes attach to the skin of the head of the man, to measure his brain activity. Such electroencephalography can make diseases such as epilepsy, or brain damage visible. The curves appear largely normal, on the one side of the head but irregularities appear.
To investigate, let the Doctors do MRI scans of the head make. The pictures scare. In the right temporal lobe of the man a large mass that pushes the brain and displaces. The physician drives now a question: What grows in the head of the man?
In addition to tumors can form in the cerebrum also Abscesses, collections of Pus require as a result of inflammation, which are also extremely dangerous – but it is a different therapy. The MRI images suggest, however, that within the mass of tissue dies. The Fund speaks for a malignant Tumor. The doctors lay the man from psychiatry to neurosurgery, where you will prepare the patient to brain SURGERY.
No Depression, call urge
The surgery is successful, Doctors cut out the tumor. Subsequent Tests confirm that it was, in fact, a malignant Tumor, a glioblastoma. The Tumor develops from the supporting tissue of the brain. As he gets often in the surrounding tissue, many patients relapse. In order to reduce the risk of irradiating the Doctors the area of the brain, they also start chemotherapy.
The brain of man before the procedure (A) according to the procedure, (B), and a year later, (C), as the Tumor returns
With the Tumor, the stiffening of the muscles and the depressed mood will disappear. The man developed a so-called frontal syndrome, he is disinhibited and has an intense urge to Call. This was probably a result of an accumulation of fluid in the brain, which is caused by the Operation, write to the Doctors in the case report. Within the following weeks, the behavior returns to normal slowly.
Five months after the procedure, the Patient can return to part-time to the work. With the consequences of the illness, he is cared for psychologically.
A year after the Operation, his condition deteriorated again. He developed panic attacks and suffers from movement, which attacked him suddenly and he can’t control. The doctors diagnose epilepsy, the origin, see the injured temporal lobes. The Tumor has returned. The doctors start the treatment with antiepileptic drugs and chemotherapy.
Further brain scans five weeks later, however, show that the Tumor has continued to grow. Four months later, the Patient dies.