| 英文摘要 |
The cerebellum is well-known to play a pivotal rôle in somatic motor function – balance, muscle tone, speech, posture, and coordination of movement. Cerebellar abnormalities in structure and function have been found in several psychiatric disorders, including schizophrenia, anxiety disorders, depression, and mania.1 But the concurrent rôle of cerebellum in cognitive function, as well as mood and psychotic disorder remains considerably less clear. Whether cerebellum is relevantly secondary or plays a primary rôle in aberrant neural network systems, remains to be confi rmed. This case provides evidence of possible association between cerebellum and psychiatric symptoms. A 24-year-old man patient with a seven-year history of psychotic symptoms was diagnosed for the fi rst time with schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSMIV TR). But he had never had brain image study to rule out brain lesion associated with psychosis. He was admitted from the psychiatric emergency department because of episodic queer posture and aggressive behavior. In the history of his initial presentation, he had restricted affect, autistic thought, a poor working memory, diffi culty in his thinking process, and hyper-religious ideation when he was 14 years old. Gradually, he showed irritability, silliness, self-talking, delusions of theft, paranoid persecutory delusions, auditory hallucinations with vocal discussion, tactile hallucinations, metamorphopsia-like experience, and a catatonia-like presentation with abrupt aggressive behavior. The fi nding of computed tomographic scan of the head showed focal enlargement of the subarachnoid space (4.5×3.0×3.0 cm3 in size) in the posterior fossa (Figure 1). |
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