Objective: We want to report a case of a patient with anxiety whose neurological symptoms were due to a basal ganglia cavernous malformation.

Background: Tremor and dizziness are common symptoms in psychiatric patients. However, these symptoms could also be a sign of an organic lesion. The basal ganglia, thanks to its rich connection with cortical and subcortical structures, is responsible for multiple functions, including executing motor programs, balance control, postural stability, muscle tone control, cognition, and somatosensory integration.

The basal ganglia cavernous malformation, through its mass effect on the neurovascular structures, can deteriorate these connections and could lead to involuntary movements, loss of balance control, and postural instability.

Method: We retrospectively searched in the database of the outpatient clinic looking for patients with anxiety whose neurological symptoms were due to an organic lesion.

Results: The psychiatric department referred to the neurological outpatient clinic a 63-year-old patient, known with anxiety disorder, hypertension and cervical discopathy, for long-standing dizziness, which appeared in open space and for right hand tremor, which started 4 months ago. The neurological examination revealed a central vestibular syndrome, a mild, bilateral, symmetric hand tremor and postural instability. With optimal anti-anxiety therapy, the hand tremor disappeared. The anti-anxiety therapy had no effect on the dizziness. Therefore, we could not attribute this symptom and the patient’s balance problem to the anxiety disorder. The laboratory assessment, including blood thyroid hormone levels, blood calcium levels, parathyroid hormone levels, ceruloplasmin level, blood copper level, was unremarkable. Magnetic resonance angiogram showed a cavernous malformation located in the left basal ganglia.

Conclusion: This case is an example of how important an interdisciplinary examination is and what an important role the basal ganglia play in maintaining balance and postural stability.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/tremor-and-dizziness-in-a-psychiatric-patient/