%0 Journal Article
%T A Novel Study of Comorbidity between Schizoaffective Disorder and Geschwind Syndrome
%A Kara O'Connell
%A Joanne Keaveney
%A Raymond Paul
%J Case Reports in Psychiatry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/486064
%X Geschwind syndrome has been described in patients with temporal lobe epilepsy and is characterized by sexual behavioural disorders, hyperreligiosity, hypergraphia, and viscosity. Presented here is a case of a 53-year-old man with clinical findings consistent with Geschwind syndrome in the setting of a known diagnosis of schizoaffective disorder, with no identifiable comorbid illness of temporal lobe epilepsy or frontotemporal dementia. Brain MRI showed bilateral temporal lobe atrophy greater than would be expected for age and more prominent on the left side than the right. It is likely that these structural abnormalities may be related to this patient¡¯s clinical presentation of Geschwind syndrome. To our knowledge, this is the first reporting of a case of Geschwind syndrome in the setting of schizoaffective disorder. These symptoms of Geschwind syndrome were present irrespective of mental state status. The report highlights the importance in correct identification of underlying cause and differentiation between Geschwind syndrome and schizoaffective disorder in order to avoid mistreatment and consequent iatrogenic adverse events. 1. Introduction Geschwind syndrome is an eponymous syndrome of interictal behaviour or personality disorder, which has been described in temporal lobe epilepsy [1, 2]. It has also been described in frontotemporal dementia [3]. Clinical features of this syndrome include preoccupation with philosophical and religious concerns, anger, excessive emotionality, viscosity (noted especially in speech), circumstantiality, altered sexuality, and hypergraphia. Recent reviews state that personality traits, rather than a personality disorder per se, seem more likely in these disorders, and they tend to resemble the cluster C category of disorders in DSM-IV [1, 2]. Schizoaffective disorder is episodic in which both affective and schizophrenic symptoms are prominent within the same episode of illness, preferably simultaneously but at least within a few days of each other. Patients who suffer from recurrent schizoaffective episodes, particularly those whose symptoms are of the manic rather than depressive type, usually make a full recovery and only rarely develop a defect state. Clinical presentations of schizoaffective disorder can include manic and depressive type states. It may therefore be difficult for clinicians to distinguish symptoms of Geschwind syndrome and those of schizoaffective manic type presentation, which can manifest as grandiose beliefs, religious delusions, and over activity. We present a novel case of a 53-year-old man
%U http://www.hindawi.com/journals/crips/2013/486064/