Psychiatry and Clinical Psychopharmacology

Frontal lobe syndrome with magical thinking: a case report

1.

Gaziantep Üniversitesi, TIp Fakültesi, Gaziantep-Turkey

2.

Gaziantep Üniversitesi Tıp Fakültesi Psikiyatri AD, Gaziantep-Türkiye

Psychiatry and Clinical Psychopharmacology 2008; 18: 309-312
Read: 707 Downloads: 458 Published: 04 March 2021

The human brain forms a lot of unique features of human behaviour and personality. As a result of a damage to a specific region of the human brain, with various reasons; permanent and mixed neuropsychiatric symptoms can be seen. Neurological deficits or sometimes psychiatric findings can be dominant. One of the cases which causes such a clinical complexity is the syndrome of frontal lobe (FLS). FLS is constituted by the damage of prefrontal lobe region of frontal lobe. It is characterized with the change in the behavior and the personality of the individuals whose previous behaviours were normal. FLS was first defined by Harlow with the case of Phineas Gage about one hundred years ago. Since then, its relationship with the behavior and personality construct still remains its mystery. The spectrum of the behavioral changes observed in the patients with frontal lesion is quite large. While some of these patients are childish, disrespectful, shabby, tactless; the others lose their spontaneity, curiosity, and initiative and they exhibit apathic atrophy in the emotions, motive, thought, and behaviours. Again some of the patients lose their insight, foresight and judgment, some of them postpone the enjoyment, and they lose their creativity, planning the complex behaviors in regular way, and also they can’t direct their attention to various events simultaneously. The ability of manipulating the focus of concentration from one to the other in a flexible way is deteriorated. They can’t follow the instructions with multisteps. In addition to these, the ability of spontaneous but inappropriate responses while sustaining the output without pressure are deteriorated in a remarkable way. However, in the literature such a phenomenon in which the deterioration of schizotypal personality and FLS were observed together hasn’t been encountered. Here, we present a case in a patient with an earlier childhood head trauma manifesting enigmatic thought and deterioration of adaption developed later in adulthood.


Büyüsel düşüncenin eşlik ettiği frontal lob sendromu: Olgu sunumu

nsan beyni, insan davran›fl›n›n ve kiflili¤inin birçok benzersiz özelli¤ini oluflturur. Çeflitli sebeplerle beynin özgül bir bölgesinin hasar› sonucu kal›c› ve karma nöropsikiyatrik klinik tablolar görülebilir. Bunlar bazen nörolojik defisitlerin, bazen de psikiyatrik bulgular›n hakim oldu¤u belirtilerle karfl›m›za ç›kabilir. Bu tür klinik karmaflaya yol açan durumlardan biri de frontal lob sendromudur (FLS). FLS, frontal lobun prefrontal bölgesinin hasar›yla oluflur. Daha önceki davran›fllar› normal olan bireylerde kiflilik ve davran›flta de¤iflim ile karakterizedir. FLS Yüzy›l kadar önce ilk kez Harlow taraf›ndan Phineas Gage vakas› ile tan›mlanm›flt›r. O günden bu yana frontal lob araflt›rmalar›na her an yeni bir bilgi eklenmesine ra¤men, davran›flla ve kiflili¤in oluflumu ile olan iliflkisi hala gizemini ve cazibesini korumaktad›r. Frontal lezyonlu hastalarda gözlenen davran›flsal de¤iflikliklerin yelpazesi oldukça genifltir. Bu hastalardan baz›lar› çocuksu, sayg›s›z, pasakl›, patavats›z olurken, di¤erleri spontanite, merak ve insiyatif kayb›na u¤rarlar ve duygu, güdü, düflünme ve davran›fllarda apatik bir körelme sergilerler. Yine bir k›s›m hasta öngörü, yarg› ve içgörü kayb› gösterirken, bir k›sm›nda da haz almay› erteleme, yarat›c›l›k, karmafl›k davran›fllar›n düzenli olarak planlanmas›, çeflitli olaylara ayn› anda dikkat yöneltebilme, konsantrasyon oda¤›n›, birinden di¤erine esnekçe yönlendirebilme yetisinde bozulma, çok ad›ml› talimatlar› takip edebilme, anl›k ama uygunsuz cevap e¤ilimlerinde bask›lanma olmadan ç›kt›y› sürdürebilme yeteneklerinin her biri kayda de¤er biçimde bozulabilir. Ancak literatürde flizotipal kiflilik bozuklu¤u ve FLS’nin birlikte görüldü- ¤ü bir olguya rastlanmam›flt›r. Biz burada; çocukluk ça¤›nda geçirilmifl bir kafa travmas›n›n ard›ndan geliflmifl büyüsel düflüncenin ve uyum bozuklu¤unun klinik tabloya hakim oldu¤u, FLS’li bir hastay› inceleyece¤iz.

Files
EISSN 2475-0581