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Case Report

JNBS. 2017; 4(3): 134-137


Electroconvulsive therapy in schizophrenia with coincidental choroidal fissure cyst: a case report

Yasin Hasan Balcioglu; Tonguc Demir Berkol; Filiz Ekim Cevik; Fatih Oncu; Guliz Ozgen.

Abstract
Choroidal fissure cyst (CFC), an intracranial space-occupying mass, is often incidentally identified and generally regarded not to present with overt clinical signs. The concurrence of space-occupying lesions with psychotic disorders have been reported in numerous cases; however, to the best of our knowledge, co-occurrent CFC and schizophrenia have not been published before in the literature. Electroconvulsive therapy (ECT) has been frequently considered relatively contraindicated in patients with spaceoccupying lesions in the brain; nevertheless, in the last few years, increased numbers of studies encourage clinicians to treat drugresistant psychiatric patients with ECT. Here we present 21-year-old male patient, who has been diagnosed with antipsychoticresistant schizophrenia with a coincidental CFC who have been clinically improved by bilateral and modified nine sessions of ECT. It is recommended to be deliberate if ECT will be applied to the patients with intracranial mass on the treatment phase. ECT may cause some side effects by increasing intracranial pressure on the patients, including rupture of cystic lesions. However, recent publications stated that ECT could be used safely in cysts, which do not cause edema or intracranial pressure increase. Our patient has not been presented any intracranial pressure signs nor neurological deficits. This report supports the safety and efficacy of ECT in the treatment of psychiatric disorders accompanied by intracranial structural lesions; nevertheless, all the risks ought to be taken into account cautiously when ECT becomes an issue for the psychiatric patients with intracranial mass and the opinion of neurosurgeons should be taken with calculating the benefit-loss ratio.

Key words: Choroidal fissure cyst;electroconvulsive therapy;schizophrenia



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