Psychiatric manifestations of Susac Syndrome: a case report

Introduction Susac Syndrome (SS) is an immune-mediated endotheliopathy that mainly affects young women. It characterized by the typical triad: subacute encephalopathy, retinal vaso-occlusive disease, and hearing loss. Encephalopathy symptoms are varied include memory loss, psychiatric disturbances, cranial nerve disorders, seizures, dementia. The syndrome considered a rare but important differential diagnosis in various neurological, psychiatric, ophthalmological, ear-nose-throat disorders. Objectives Report clinical case of SS to reflect on relationship between neurological symptoms. Methods Collection information from patient described below. Review literature about SS. Results A 21-year-old woman presented Psychiatry Emergency Department November 2021 for complaints sadness, anhedonia emotional lability, with one month evolution. She also had insomnia confusional periods, so she stopped driving quit her work as storekeeper. was given sertraline 50mg/day trazodone 50mg/day. In past two weeks, episodes headache vomiting, 8 kg weight started fever (38.5ºC) days before observation. prior history depressive symptomatology four years earlier related father’s grief medical surgical unremarkable. brought wheelchair mother using diapers because confined bed week. Objectively, somnolent, tearful confused, scarce speech psychomotor slowing. No focal signs were found examination. Collaboration Neurology asked. Routine laboratory studies showed slight increase leucocyte count (12 500/mm3) CRP (17mg/dL). Cerebrospinal fluid analysis 15 cells/uL protein 2.64 g/L. Cerebral MRI multiple striatocapsular periventricular lesions involving thalamus, left midbrain, medulla oblongata, well bilateral hemispherical cerebellar subcortical lesions. high signal T2 restriction diffusion study. admitted inpatient department treated pulse methylprednisolone 1000 mg/day five consecutive days, after which cognitive function improved. Ophthalmology observation cotton-wool exudate arteriolar interruption right eye, supporting Conclusions This represents importance diligent cooperation among different specialties improve diagnosis-making, treatment recovery. Psychiatric frequent syndromes, degree suspicion needed. Disclosure Interest None Declared