Abstract:

Menstruation related recurrent psychosis (MRRP) is a rare disease. Its etiology is still unclear. The hormonal changes of the menstrual cycle may be contributing to the pathophysiology of psychiatric conditions. Case Report: A 16-year-old female patient was referred to our pediatric neurology outpatient clinic for further examination. About 2 years ago, she suddenly complained of inability to speak, inability to stay alone, forgetfulness, refusing to eat and numbness involving her left face, and had no seizures. All psychiatric complaints lasted for a week per month and resolved spontaneously. For the last two years, she had history of multiple admissions for brief delusional episodes to another hospital. In the period following the onset of complaints, each family noticed that the child’s complaints occur during each menstrual cycle. After each menstrual period, every symptom disappears completely and does not require treatment with anti-psychotic medication. There is no history of trauma, fever or toxic exposure. There is no family or personal history of any psychiatric or neurological illness. She was hospitalized at another center and examined for infectious, metabolic, autoimmune and toxic causes. All the test results were normal. She was diagnosed with MRRP and started with quetiapine. On the third day, she showed a significant improvement in symptoms, and we stopped any medication. If the patient had similar complaints in the next episode, the same treatment was planned. She has been regularly followed-up for four months and did not yet have a heavy attack requiring antipsychotics. Conclusion: We present a patient with menstruation induced psychosis, due to its rarity. It is important to publish such cases in order to determine the actual incidence. Neurological examination of patients presenting with psychiatric symptoms is important but the relationship between the findings and menstrual cycle and history of spontaneous improvement after the period should be questioned.

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