ECE2020 Audio ePoster Presentations General Endocrinology (17 abstracts)
Mental disorders in adult patients with diencephalon lesions by craniopharyngiomas.
Yuliya Sidneva 1,2 , Ludmila Astafyeva 1 , Oleg Zaitsev 3 , Sergey Urakov 4 , Pavel Kalinin 1 , Maxim Kutin 1 , Boris Kadashev 1 , Aleksey Shkarubo 1 , Dmitry Fomichev 1 , Dmitry Andreev 1 , Oleg Sharipov 1 , Irina Voronina 1 , Shukur Abdulatipov 1 & Iliay Chernov 1
1NN Burdenko National Medical Research Center of Neurosurgery, Pituitary, Moscow, Russian Federation; 2Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Rehabilitation, Moscow, Russian Federation; 3NN Burdenko National Medical Research Center of Neurosurgery, Neuropsychiatry, Moscow, Russian Federation; 4NN Burdenko National Medical Research Center of Neurosurgery, Diagnostics, Moscow, Russian Federation
The tumors of the thalamic-hypothalamic-pituitary system (diencephalon region, DR) include a fairly large group. These are pituitary adenomas, craniopharyngiomas (CP), pineal tumors, gliomas, meningiomas, and others. Tumors differ in the location, histological structure, and manifestations of the clinical picture with the corresponding hormonal changes, approaches and methods in treatment. Psychopathological symptoms are revealed in the symptoms of lesion of the DR in addition to cerebral, neuroendocrine symptoms, neurological disorders. It is represented by emotional, motivational, personal, cognitive impairments, inversion of the sleep-wake cycle, seizures.
Objective: To study of mental disorders in patients with diencephalon lesions (on a model of benign tumor of craniopharyngiomas).
Materials and methods: 120 adult patients (18–68 years old, median 39 ± 2; 59 women and 61 men) who were first admitted for treatment with a diagnosis of CP (2007–2015). The main method was psychopathological; data from endocrinological, neurological, neuroimaging. CP were classified according to initial growth and relation to the third ventricle: endosuprasellar (n = 26), suprasellar (with initial growth in the pituitary stalk, with no penetration into the third ventricle) (n = 45), extra-intraventricular (n = 35) and intraventricular (n = 14). Hypopituitarism/panhypopituitarism, diabetes insipidus was detected in 89%before surgery.
Results: Mental disorders in the clinical picture of CP were detected in 103 (85.8%) patients with syndromes: emotional and volitional disorders in 79 (65.8%), memory impairment in 71 (59.1%), personality changes in 71 (59.1%), paroxysmal conditions in 55 (45.8%), sleep disorders in 54 (45%), and consciousness disorders in 24 (20%). Mental disorders do not manifest themselves in isolation, but together with each other, and therefore are superior to each other in the clinical picture or to varying degrees with various topographic and anatomical variants of CP : in 65% of cases with endosuprasellar, in 86% – with stalk, in 100% – with extra-intra- and intra-ventricular CP. The most severe mental disorders: Korsakov’s syndrome, aspontaneity, akinetic mutism, personality defect were noted in 21% of cases, more often in patients with extra-intra--ventricular CP.
Conclusion: Mental disorders in the clinical picture of CP were detected in 85.8% of patients before surgery, determined by the location of the damage – topographic and anatomical variants of CP, the spread and effect of the tumor on the structures of the DR, limbic system, and III ventricle, with corresponding neuroenodcrine disorders.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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