See also- Autoimmune Encephalitis (including PANDAS/PANS)
BBC Ideas: The misdiagnosis that sent me to psychiatric hospital
Hannah had autoimmune encephalitis but was misdiagnosed as mentally ill.
The Misdiagnosis Machine: How Thyroid Problems Mimic the Symptoms of Mental Illness
Mitochondria - The Key To Disease and Mental Health with Dr. Martin Picard
Are Mental Illnesses Really Metabolic Disorders? | with Dr. Chris Palmer
Hypokalemia can cause delirium, depression, delusions, hallucinations, psychosis. Physical signs include cramps, nausea, heart arrhythmia, fatigue, paralysis, tachycardia
Vitamin D deficiency Helps depression and can reduce suicide by 45% Veterans see Study.
The Lactic Acid Response to Alkalosis in Panic Disorder : An Integrative Review
"Panic patients consistently show exaggerated lactic acid response to alkalosis, whether produced by hyperventilation or by sodium lactate infusion. Understanding why this occurs may provide important clues to the pathogenesis of panic disorder. Although brain hypoxia from excessive hypocapnia-induced cerebral vasoconstriction is often cited as the mechanism of elevated brain lactic acid in panic disorder, studies of brain metabolism show that hypocapnia rarely leads to brain hypoxia. Increased lactic acid production is a normal response to intracellular alkalosis and to intracellular cyclic AMP. Thus, other possible mechanisms of the exaggerated lactic acid response in panic disorder include a disturbance of mechanisms regulating intracellular pH and factors increasing intracellular cyclic AMP. Both mechanisms are consistent with the suffocation false alarm theory of panic disorder. This review suggests a theoretical framework for future magnetic resonance spectroscopy studies that can test some of the predictions of these competing models."
"Cerebellar Cognitive Affective Syndrome: Anatomy & Implications" - Jeremy D. Schmahmann, MD
A patient with dementia and schizophrenia returns to previous functioning after surgery to correct a chiari and syrinx. Symptoms included school failure, manic, obsessive, compulsive, ruminative, treated for ADHD with poor results, anxiety, racing thoughts, hostile/aggressive, poor processing of conversations and loss of social skills, profanities, meanness, headaches, gait abnormalities, reclusive, depression. After treatment, psychiatric issues gone, IQ still 148 but grades not fully back.
Another case- developmental delay, expressive language more affected than receptive, sensory-motor, executive function impairments, ASD diagnosis. “seizure-like episodes” confusion, involuntary movements, uncharacteristic behaviors in “episodes”. Worsening- autism, OCD, communication shut down, worse anxiety, tics; intrusive thoughts, ritualistic behaviors, insomnia, trance-like states in which he doesn’t seem to know his location or recognize his family. Car rides would create “sensory episodes”. Self-injury, laughing/coughing episodes, inappropriate laughter. Decompression of brain stem ended seizure/tremor like episodes and pain, present and enjoying family, still reserved. “It is apparent that the decompression of the brain stem/cerebellum/medulla and restoration of the CFS flow has eliminated the seizure-like tremoring, and other acute neurologic havoc that escalated to a dangerous neuro-psychiatric state when left unaddressed or otherwise mistreated for 11 months.”
“Phenomenon of autistic-like behaviors that resolve after decompression surgery”
Cerebellar syndrome started as gait impairment, speech trouble, difficulty coordinating arms, oculomotor abnormalities. Most of the cerebellum in humans is not related to motor control. CURRENT- executive function (planning, set shifting, verbal fluency, abstract reasoning, working memory), spatial cognition (visual spatial organization and memory), language deficits (agrammatism, aprosodia, anomia), personality change (blunting of affect, disinhibited and inappropriate behavior). Trouble multitasking. In kids, memory problems can look like dissociation, fracturing. Cerebellar Mutism Syndrome-maximally severe CCAS- profound buccofacial apraxia and apraxia of speech, emotional dysmetria, may include ataxia and cranial nerve palsies. Cerebellar agenesis- surprisingly good motor abilities, child-like speech, reduced intellectual and executive functioning. No ataxias in which cognition is entirely spared.
“cerebellum optimizes performance by modulating behavior around a homeostatic baseline automatically, implicitly, and according to context.
