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Schizophrenia, as a chronic disease with a high recurrence rate, mainly has a greater impact on an individual's overall social functions, including occupational functions, social interaction skills, and social adaptability. First, the patient may not have the ability to work or study, and may not be able to complete the normal work and study that ordinary people can complete; secondly, the patient may not be able to establish good interpersonal relationships with other people in society, and may not be able to adapt well to society. As family members, we must all hope that there will be a good way to cure the patient's mental symptoms, return to the workplace or school, and become a person who can support himself and be useful to the family and society. Based on this, this article will describe the illness and treatment process of the case patient in as much detail as possible, use this case review to explore the diagnosis and psychopathology of schizophrenia, and provide feasible treatment strategies for the patient's family members.
Patient gender: male Age: 25 years old
Disease status: Schizophrenia 5 years
Medication status: Risperidone , Olanzapine , Aripiprazole
Disease description: patient in 2016 The onset of the disease started with insomnia and auditory hallucinations, in which he heard his neighbors talking bad about him, accompanied by talking to himself. At the end of the same year, the patient showed strange behaviors such as clasping his hands, mumbling to himself, kowtowing and closing his eyes. He complained that he could see Bodhisattva. He went to the local mental health center and was diagnosed with schizophrenia. He was given risperidone and other drugs, and his condition improved. After being discharged from the hospital, the patient stopped taking the medicine and his condition relapsed. He heard someone say out of thin air that he was not the biological child of his parents. He believed that his mother had installed bugs and monitors in his room, so he did not dare to speak at home. He often argued with his mother and would fight when he was impulsive. He scolded his mother and was hospitalized four times. He took olanzapine, aripiprazole and other drugs, but his condition still recurred, so he had to take a leave of absence from school to recuperate at home.
At the end of 2021, the patient went to Shanghai Oriental Hospital with his parents to consult on the feasibility of surgical treatment. Considering that the patient was still young and the duration of the disease was more than 3 years, he had taken antipsychotic drugs in sufficient amounts and for a sufficient course, but there was no evidence of any symptoms. With obvious curative effect, he was admitted to the hospital with " refractory schizophrenia" from the outpatient clinic. Before surgery, CT, MRI, and DTI scans were scanned, and then calculated by computer positioning software to perform precise target positioning. During the operation, a small incision of about 3cm was made on the patient's head, a small bone hole of 1cm was drilled, and with the help of specific electrodes, radiofrequency ablation was performed on specific nerve nuclei target points in the brain. The operation took about 4 hours to complete.
After the operation, the patient's hallucinations and delusions faded, his sense of reality increased, his temper became milder, he denied seeing the Bodhisattva and his parents who were not biological, admitted that he was ill, and promised to cooperate with follow-up drug treatment. Two months after the operation, the patient's auditory hallucinations completely disappeared. After taking antipsychotic drugs stably, there were no recurrences of hallucinations and delusions. Especially after exchanging heartfelt conversations with his mother, the knot between mother and child was resolved, and the family relationship returned to its former self. harmony. During the six-month postoperative follow-up, the patient's medication dosage was reduced to 1.5 mg of risperidone, and her symptoms were under stable control. She is currently preparing for the resumption of school at home in the second half of the year.
Wu Jingwen, director of the Functional Neurology Department of Shanghai Dongfang Hospital, said that fifth-generation brain stereotactic surgery is an effective complementary treatment for refractory schizophrenia. On the one hand, most of the stubborn mental symptoms of postoperative patients can be effectively controlled and eliminated; on the other hand, their human nature and emotions return to normal, their insight is restored, and they voluntarily accept follow-up treatment. This highly minimally invasive surgical positioning is very precise, down to the millimeter. It also has minimal trauma, few complications, and fast recovery. It will not affect the normal function of the brain and will not damage the patient's intelligence. For patients with mental illness such as refractory schizophrenia, bipolar disorder , depression , anxiety disorder, etc., if their mental symptoms are still uncontrollable after more than 3 years of regular drug treatment, or they do not cooperate with the treatment, and the amount of medication they take, If it is too large and the side effects cannot be tolerated, it can be treated with minimally invasive surgery after a comprehensive evaluation.
To the readers:
Hello, I am Dr. Wu Jingwen. Thank you very much for reading my article. If you have any illness and want to consult me, you can contact me via "private message" on the platform. You can also leave a message under the article and I will answer your questions as soon as possible.
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