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Yıl:2019; Cilt: 6; Sayı: 1>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2019;6(1):67-69
İki şizofreni vakası; klinik gidiş ile cavum septum pellucıdum ilişkisi
YE Yıldırım, E Sert, PÇ Aydın, TD Berkol, S Kunt
Bakırköy Ruh Sağlığı ve Sinir Hastalıkları, İstanbul
Lateral ventriküllerin medial duvarını oluşturan septum pellucidum iki laminadan oluşmaktadır. Bu laminalar arasında boşluk oluştuğunda Cavum septum pellusidum (CSP) olarak tanımlanmaktadır. Bazı MR çalışmalarında, şizofreni tanılı hastalarda normal kişilerden daha yüksek oranda geniş CSP saptanmıştır. Psikiyatrik bozukluklarla ilgili literatüre bakıldığında CSP’un en çok şizofreni ile bağlantılı olduğu gösterilmiştir. Geniş CSP şizofreninin etiyolojik açıklamalarından biri olan nörogelişimsel modeli desteklemektedir. Çalışmamızda CSP tanısı olan iki olgudan bahsedilmektedir. Hastalarımızdan biri ilk episod şizofreni olup, diğeri geçmişte çok ilaca direnç öyküsü olan bir kronik şizofreni hastasıdır. İlk edisod şizofreni olgumuzun belirtilerin şiddeti, tedaviye yanıtsızlık ve nöropsikolojik testlerdeki yetersizlik açısından literatürde mevcut olan bilgilerle uyuşmaktadır. Kronik şizofreni olgumuzun yıkımının belirgin olması hastalık süresi ve tedavi uyumsuzluğunun yanında CSP’nin şizofreninin etiyolojisindeki nörogelişimsel modeli düşündürmektedir. Şizofrenide geniş CSP ile literatürde tedaviye yanıtın karşılaştırıldığı bir araştırmaya rastlanmamıştır. İlerideki araştırmalarda tedaviye yanıtın araştırılması nörogelişimsel modelin psikiyatrik bozuklukların tedavisindeki etkilerinin gösterilebilmesi için önemli olduğu düşünülmektedir.
Two cases of schizophrenia; the relationship between cavum septum pellucidum and clinical course
Septum pellucidum, which forms the medial wall of the lateral ventricles, consists of two laminates. Cavum septum pellucidum (CSP) is defined when there is a space between these laminae. In some MRI studies have shown a higher rate of large CSP in patients with schizophrenia than in normal subjects. Looking at the literature on psychiatric disorders, CSP has been shown to be most associated with schizophrenia. Large CSP supports the neurodevelopmental model, which is one of the etiological explanations of schizophrenia. In our study, two patients with a diagnosis of CSP are mentioned. One of our patients is a first episode of schizophrenia, and the other one chronic schizophrenia patient with a history of multi-drug resistance. The first episode of schizophrenia is consistent with the information available in the literature in terms of the severity of symptoms, weak-response to treatment, and insufficiency of neuropsychological tests. The apparent deficit of the chronic schizophrenia patient suggests that CSP has a neurodevelopmental model in the etiology of schizophrenia, as well as the duration of the disease and non-compliance with treatment. There is no study in the literature comparing the response to treatment with large CSP in schizophrenia. It is thought that investigation of response to treatment in future studies is important for demonstrating the effects of neurodevelopmental model on the treatment of psychiatric disorders.

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