Complex Neuropsychiatric Manifestations in Binswanger Disease: A Case Report

Abstract

ABSTRACT “Binswanger disease” is a controversial eponym frequently used to indicate a form of vascular dementia characterized by white matter rarefaction and lacunar infarcts. Clinical features of Binswanger disease are variable, and the psychiatric manifestations have been less well described. We report a case of a 78-year-old female presenting with 3-month history of precognitive experiences, hallucinations in multiple modalities, inappropriate behavior, insomnia, and deterioration in self-care. Patient is a known case of hypertension and has a past history of multiple transient ischemic attacks. Mini-Mental State Examination, Montreal Cognitive Assessment, and Frontal Assessment Battery showed significant dysfunction. Neuropsychiatric inventory confirmed presence of psychopathology. Salient findings on magnetic resonance imaging brain included cerebral atrophy, chronic white matter ischemic changes, and multiple lacunar infarcts. The patient was prescribed second-generation antipsychotic along with cholinesterase inhibitor, NMDA receptor antagonist, and an antihypertensive. The patient improved with regard to psychotic symptoms and insomnia and is attending regular follow-up. How to cite this article: Saldanha NC, Balasundaram S, Choudhury S, Sarkar S. Complex Neuropsychiatric Manifestations in Binswanger Disease: A Case Report. J Basic Clin Appl Health Sci 2020;3(4):171–173.