We report a 70 year-old man with Binswanger's disease associated with mood symptoms. He was apparently well until 15 years ago when the treatment-resistant atypical mood symptoms had been appeared. He showed a fluctuating course in mental disturbance,...
We report a 70 year-old man with Binswanger's disease associated with mood symptoms. He was apparently well until 15 years ago when the treatment-resistant atypical mood symptoms had been appeared. He showed a fluctuating course in mental disturbance, such as irritable and labile affect, emotional incontinence, and irritable behavior. Two years ago, he was diagnose as hypertension, renal failure, and heart failure. He was admitted to psychiatric ward due to irritable mood, dysarthria, lack of bladder control, gait disturbance, and impulsive behaviors, which had been aggravated during the last 2 months.
In physical examination, he had hypertension and both pretibial pitting edema was revealed, and also in neurological examination, exaggeration of deep tendon reflexes and weakness of extremities were found. On mental status examination, he showed irritable and labile mood with mild cognitive disturbances. Brain MRI demonstrated multifocal high signal intensity in periventricular white matter, both basal ganglia, and thalami on the T2 imaging. These findings were compatible with Binswanger's disease with mood symptoms.