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Yıl:2007; Cilt: 10; Sayı: 1>> Özet
TAM METİN
Klinik Psikiyatri Dergisi; 2007;10(1):53-57
Kavum Septum Pellusidum ile Obsesif Kompulsif Bozukluk ve Tourette Bozukluğu İlişkisi: Bir Olgu Sunumu
E Onur, T Alkın, E Ada
Dokuz Eylül Ü. Tıp Fak. Psikiyatri ABD
Normal fetal gelişim sırasında septum pellusidumun oluşumu komşu limbik yapıların gelişimi ile eş zamanlıdır. Bu yapılarda meydana gelen disgenezisinin yapışma sürecini bozarak kavum septum pellusidum (KSP) oluşumuna yol açabileceği varsayılmaktadır. Dolayısıyla, KSP'nin çocuklukta ve erişkinlikte saptanmasının söz konusu yapılardaki olası embriyonel gelişim bozukluklarını yansıtabileceği öne sürülmüştür. Normallerde de sık saptanmasından dolayı, KSP'nin ancak geniş olması halinde patolojik süreçlerle ilişkilendirilebilir. Şizofreni ile "geniş KSP" ilişkisi birçok araştırmayla gösterilmiştir. KSP'nin diğer nöropsikiyatrik bozukluklarla ilişkisi henüz açıklığa kavuşmamıştır. Anksiyete bozuklukları alanında KSP ile ilgili olarak literatürde yalnızca panik bozukluğu ve travma sonrası stres bozukluğu konusunda bildiriler bulunmaktadır. Bu yazıda obsesif kompulsif bozukluk ve Tourette bozukluğu tanısı alan bir olguda saptadığımız "geniş KSP'nin" (18 x 13.5 x 20 mm) önemi, ilgili literatüre temelinde ve anksiyete bozuklukları bağlamında tartışılmıştır. Gelecekte KSP'nin, intrauterin dönemdeki nörogelişimsel bozulmaları yansıtan bir bulgu olarak başta obsesif kompulsif bozukluk olmak üzere tüm anksiyete bozukluklarındaki varlığının ve olası ilişkisinin araştırılması, bu bozuklukların etyopatogenezinin anlaşılmasına katkıda bulunabilir.



The Relationship of Cavum Septum Pellucidum with Obssessive Compulsive Disorder and Tourette Disorder: A Case Report
In normal fetal development, the formation of septum pellucidum occurs at the same time with the development of the neighboring limbic system structures. It was hypothesized that the dysgenesis of these structures leads to arrest of the fusion process, and thus resulting formation of cavum septum pellucidum (CSP). There is a high variance in the prevalence of CSP in normal adults. Hence, it was suggested that only large CSP is related with pathological processes. Several magnetic resonance imaging studies have reported a higher prevalence of enlarged CSP in patients with schizophrenia than in normal subjects. However the relationship of CSP and other neuropsychiatric disorders remained unresolved. In the context of anxiety disorders only reports on the relationship of CSP and panic disorder, and post-traumatic stress disorder were available in literature. In this report we present an obsessive compulsive disorder and Tourette disorder case with enlarged CSP (18 x 13.5 x 20 mm) detected by brain tomography. The importance of enlarged CSP was discussed in the context of anxiety disorders. CSP, which is a sign reflecting neurodevelopmental disturbance, should be considered in understanding the etiopathogenesis of anxiety disorders. It is relevant to investigate in future studies the prevalence and relationship of CSP with other structural abnormalities in patients with obsessive compulsive disorder.

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