PT  - JOURNAL ARTICLE
AU  - Andrews, John Paul
AU  - Taylor, Joseph
AU  - Saunders, David
AU  - Qayyum, Zheala
TI  - Peduncular psychosis
AID  - 10.1136/bcr-2016-216165
DP  - 2016 Aug 10
TA  - BMJ Case Reports
PG  - bcr2016216165
VI  - 2016
4099  - http://casereports.bmj.com/content/2016/bcr-2016-216165.short
4100  - http://casereports.bmj.com/content/2016/bcr-2016-216165.full
AB  - Psychotic symptoms are rarely documented in association with cortex-sparing central nervous system (CNS) lesions limited to the midbrain. We present the case of a 15-year-old boy with hereditary and environmental risk factors for psychiatric illness, as well as a history of midbrain pilocytic astrocytoma treated with chemotherapy and focused radiation, who presented with non-epileptic seizures, hyper-religiosity and frank psychosis. The space-occupying midbrain lesion has been radiographically stable while the patient has decompensated psychiatrically. Differential aetiology for the patient's psychiatric decompensation is discussed, including psychosis secondary to a lesion of the midbrain. Literature linking midbrain lesions to psychotic features, such as in peduncular hallucinosis, is briefly reviewed. This case suggests that a midbrain lesion in a susceptible patient may contribute to psychosis.