Episod maniacal indus prin corticoterapie postalblaţie de meningiom spinal. Rolul realităţii virtuale în psihoterapia anxietăţii postoperatorii

Abstract

Corticosteroids have been linked to various neuropsychiatric adverse effects, including mood disorders. This case study describes a post-surgical manic episode (spinal meningioma ablation D11-D12) in a 57-year-old female patient on corticosteroids. This presentation aims to highlight corticosteroids’ potential psychiatric adverse effects and to emphasize the importance of recognizing and treating such complications. In this case, the management strategy involved discontinuing corticosteroids, initiating mood-stabilizing medications, and closely monitoring the symptoms. A mood stabilizer and a second-generation antipsychotic were administered to the patient to treat transient manic symptoms and prevent relapse. After discontinuing corticosteroids and beginning therapy with mood stabilizers, the patient’s bipolar symptoms improved. Psychoeducation and therapeutic support were provided to aid the patient in managing acute symptoms and encourage adherence to the treatment plan. As anxiety persisted after manic symptoms were controlled, the case management involved a psychotherapy technique facilitated by virtual reality. Relaxation breathing techniques were emulated through a virtual reality Oculus Quest 2 headset, improving patient-physician trust, subjectively relieving correlated anxiety, and ensuring therapeutic compliance during the admission and at home. Healthcare professionals must be vigilant to identify and effectively treat these complications of steroid anti-inflammatory medication. Immediate cessation of corticosteroids, the initiation of mood stabilizers and psychoeducation are essential for managing these cases. By presenting this case report, we hope to increase healthcare professionals’ awareness on the psychiatric consequences of corticosteroid use, the necessity of a multidisciplinary therapeutic approach, and the role of add-on virtual reality as integrated, personalized patient care to alleviate anxiety.