RESUMO
Thalamic dysfunction has been associated with schizophrenia and other psychotic disorders. We describe an adult patient with a lacunar infarct in the posterior region of the right thalamus exhibiting a paranoid schizophrenia-like psychosis as the only clinical manifestation. Neuropsychological assessment showed alterations in visuospatial memory and executive functions at follow up. This case highlights the role of information processing by the thalamus in the development of delusions. We suggest that dysfunction of the right mediodorsal and pulvinar thalamic nuclei disrupts both thalamic sensory processing and thalamo-prefrontal circuits mediating belief evaluation, leading to delusional beliefs.
Assuntos
Esquizofrenia Paranoide/etiologia , Acidente Vascular Cerebral Lacunar/psicologia , Doenças Talâmicas/psicologia , Adulto , Antipsicóticos/uso terapêutico , Delusões/etiologia , Delusões/psicologia , Humanos , Masculino , Transtornos da Memória/etiologia , Transtornos da Memória/psicologia , Testes Neuropsicológicos , Risperidona/uso terapêutico , Esquizofrenia Paranoide/tratamento farmacológico , Esquizofrenia Paranoide/psicologia , Psicologia do Esquizofrênico , Acidente Vascular Cerebral Lacunar/complicações , Doenças Talâmicas/complicações , Doenças Talâmicas/tratamento farmacológico , Núcleos Talâmicos/patologia , Percepção Visual/fisiologia , Escalas de WechslerRESUMO
Chronic delusions are one of the organization units of modern psychiatry since it took shape around the middle of the 19th century. This paper states the emergence and differentiation process of these clinical manifestations in relation to the different theoretical frameworks that explain them, from the 19th century to the rise of encompassing classifications (DSM and CIE) while pointing out their inclusion or disappearance. Then it exposes the clinical characteristics of the appearance and evolution of its main clinical manifestations.