A 71 year-old hypertensive right-handed man presented a small intracerebral haematoma limited to the left subthalamic nucleus that resulted in right hemiballismus and a neurobehavioral disinhibition syndrome. The latter associated logorrhoea and euphoria, but there was no frontal signs nor mental confusion. The patient kept full insight into his mental change, that contrasted with his prior personality. Hemiballismus and the manic-like state resolved within 2 months. This case and some others from the literature illustrated that a focal lesion in the basal ganglia could result in manic-like affective change, and that a relation did exist between hyperkinetic syndrome and euphoria. Our case contrasted with most of the published cases of neurobevioral changes following basal ganglia discrete lesions, expressing as hypokinesia, apathy and loss of motivation. With reference to the functional circuits linking the frontal cortex and the basal ganglia, as described by Alexander, this syndrome of combined disinhibition of motricity, speech and affect could involve either the lateral orbito-frontal or the anterior cingulate loops, more especially the indirect pathways travelling through the subthalamic nucleus, lesion of which is known to disinhibit thalamo-cortical activity.

Aged↗

PubMedDate not supplied

[Death or absence of the father. Its role in the genesis of psychotic process happening between 15 and 25 years].

A retrospective study of the case records of 215 patients developing an acute or chronic psychotic process between the ages of 15 and 25 years indicated that the father had died or disappeared during childhood in 25% of cases, a figure of 7% being found for a control group - a highly significant statistical difference. By contrast, there was no statistically significant difference in the disappearance of the mother between the two groups. The date of death (or disappearance) of the father occurred at three particular periods - at birth, towards the age of 5 and at 11 or 12 years. The authors' discussion concerns the convergence of the results of this statistical approach of the past history of psychotic patients with certain psychodynamic interpretations of psychosis.

Adolescent↗