Case ReportNeuropsychiatric Manifestations of Partial Agenesis ofthe Corpus Callosum: A Case Report and Literature Review

Olusegun Popoola ,1 Olaniyi Olayinka ,1 Heela Azizi ,2

Chiedozie Ojimba,1 Tasmia Khan,3 Jisha Kallikkadan,4 Maleeha Ahmad,2

Joshua Jay,5 Cecilia Canale ,4 Sherina Langdon,2 Alexa Kahn,2

Deepa Nuthalapati,2 Sinthuja Jayaraj,2 Ayesha Mahbub,1 Olalekan Olaolu,1

Kodjovi Kodjo,1 Tolu Olupona,1 Carolina Nisenoff,1 and Ayodeji Jolayemi1

1 Interfaith Medical Center, New York Department of Psychiatry, Brooklyn, NY, USA2American University of Antigua College of Medicine, Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA3Medical University of the Americas, Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA4Extern, Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA5St. Matthews School of Medicine, Department of Psychiatry, Interfaith Medical Center, Brooklyn, NY, USA

Correspondence should be addressed to Olusegun Popoola; opopoola@interfaithmedical.com

Received 20 January 2019; Accepted 6 March 2019; Published 25 March 2019

Academic Editor: Erik Jonsson

Copyright © 2019 Olusegun Popoola et al. This is an open access article distributed under the Creative Commons AttributionLicense, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited.

Agenesis of the corpus callosum is a rare congenital defect that has been linked to psychiatric disorders, cognitive deficits, learningdisabilities, and developmental delays. We present the case of a patient with partial agenesis of the corpus callosum who exhibitsdepressed mood, transient loss of memory, and history of cognitive, social, and behavioral disturbances that developed during hischildhood. Recent and pertinent literaturewas reviewed and the agenesis of the corpus callosum and its associated neuropsychiatricmanifestations are discussed.

1. Introduction

The implication of the partial agenesis of the corpus callosumin the development and manifestations of a psychiatricdisorder is not fully understood. The corpus callosum is themost massive white matter structure in the brain that isinvolved in the exchange of information between the cerebralhemispheres. The corpus callosum develops between theeighth and 20th week of pregnancy, and its developmentcan be halted during this period [1]. Complete or partialagenesis can occur as part of a syndrome or in isolation [1].Nonsyndromic isolated agenesis of the corpus callosum canbe asymptomatic. However, the prevalence of asymptomaticcases is not known. The incidence of agenesis of the corpuscallosum has been reported to be between 0.05 and 0.7percent of the general population with a male predominance[1]. Despite the proximity of the corpus callosum to the

cingulate gyrus, which plays a critical role in the regulationof mood, the implication of its anomaly is yet to be clearlyunderstood. Some neuropsychiatric manifestations such asunipolar depression, bipolar depression, schizophrenia, andsevere behavior problems have been linked to the agenesis ofthe corpus callosum, further making the actual correlation ofcorpus callosum anomalies to psychiatric disorders unequiv-ocal [2, 3].

These neuropsychiatric disturbances notably observedin patients with corpus callosum anomalies have raisedquestions regarding the effect of corpus callosum atrophyand agenesis. The current literature demonstrates potentialassociations between features of psychosis and corpus callo-sum degeneration or agenesis [4–6]. Previous research hasshown some disruption of emotional processing in patientswith corpus callosum irregularities [7]. Patients have alsobeen shown to have a potential predisposition to psychosis

HindawiCase Reports in PsychiatryVolume 2019, Article ID 5925191, 8 pageshttps://doi.org/10.1155/2019/5925191

2 Case Reports in Psychiatry

in the case of agenesis of the corpus callosum, andmany havespecifically experienced delusions [4, 5].Though the researchin patients with corpus callosum agenesis is expanding,many questions are unanswered. The research highlightssome psychotic symptoms and emotional dysregulation butis lacking in outlining common symptomatology of cor-pus callosum atrophy and agenesis. As of yet, there areno well-defined syndromic classification of corpus callo-sum pathology. In this report, we aim to discuss corpuscallosum pathology as a grouping of specific psychiatricmanifestations.

2. Case Presentation

We describe the case of a 45-year-old Hispanic man whopresented to the psychiatric emergency room on accountof depressed mood and forgetfulness. He was found by hisniece sitting in the bathroom batting away imaginary fliesand crying, stating that he could not remember anythingwhich prompted his niece to call emergency medical services(EMS).

The patient was emotionally labile and could not remem-ber his name or address at the time of presentation. He washyperverbal and difficult to interrupt, and his speech wasdisorganized. The patient stated that prior to admission, heleft his home and suddenly could not remember how he gotto the location he had traveled to. He then returned homeand entered the bathroom to look for a belt to hang himselfwith, because he could not remember any of the evening’sevents. He stated that he felt lonely and helpless and that hehad suicidal thoughts. The patient stated that his sleep hadbeen poor. He endorsed a perceptual disturbance of seeingfleas that were trying to infest his body. He also endorsedan auditory hallucination of a male voice calling his name.Collateral information from his niece, who called the EMS,revealed that the patient had been acting bizarre with twoprevious episodes of new-onset wandering behavior in thepast six months, both associated with heavy alcohol use.She also reported that the patient had a 15-year history ofschizophrenia and that he had had similar episodes in thepast, which were usually brief and resolved without the needfor hospitalization. During a similar episode three years ago,the patient began attacking his family members and was hos-pitalized after the police were called.The patient also receiveda diagnosis of major depressive disorder five years ago. Thepatient was admitted to the inpatient psychiatry unit with adiagnosis of major depressive disorder. Urine toxicology atthe time of admission was negative for controlled substances,illicit drugs, and alcohol. The patient’s admission CompleteBlood Count (CBC) and kidney liver function tests werewithin normal limits. Rapid regain test was negative. Serumsodium and potassium were 138mmol/L (136–144.0mmol/L)and 4.4mmol/L (3.6–5.1), respectively. Other routine urineanalyses and coagulation profiles were also within normallimits as were routine chest radiograph and ECG. Serumthyroid stimulating hormone was below the lower limit ofnormal 0.409 uIU/ml (0.450–4,500 uIU/ml) and free T4 was1.09 ng/ml (0.82–1.77 ng/dL). The patient had no symptomsof hyperthyroidism.

Figure 1: MRI demonstrating partial agenesis of the corpus callo-sum with the absence of the posterior body and the splenium.

Other chemical laboratory investigations were withinnormal limits except for dyslipidemia. Computerized tomog-raphy (CT) and magnetic resonance imaging (MRI) per-formed during admission revealed partial agenesis of thecorpus callosum with the absence of the posterior body andthe splenium as shown in Figure 1.

On day 1 of hospitalization, the patient was hyperactiveand restless on the unit. He was treated with escitalopram10 mg PO daily and risperidone 2 mg PO BID. By day 2 ofhospitalization, the patient was able to recall his name and hisperceptual disturbances resolved, but hewas still hyperverbal,with increased activity. By day 9 of hospitalization, thepatient’s condition had stabilized, and he was discharged.

According to the patient’s mother, the pregnancy wasreported to be complicated at five months, and the patientwas born at seven months. He had normal gross motor devel-opment, but language was delayed until the age of 7 years.The mother reported a history of cognitive developmentaldelay and intermittent behavioral disturbances that led to hisdropping out of school in fifth grade.

3. Literature Review

We conducted a literature review to explore various neu-ropsychiatric manifestations of agenesis of the corpus cal-losum presented in this case report. This was focused onidentifying peer-reviewed articles related to partial agenesisof the corpus callosum and pathology. We searched PubMed,EBSCO, and Web of Science for articles on the function ofthe corpus callosum and presentation when absent or whenthere is a lesion without language restriction or restriction totime-period. The search was conducted using the keywordsand MeSH terms: “function” “agenesis” “corpus callosum”,“schizophrenia”, and “psychosis.” Screening for eligible arti-cles was conducted independently by six authors. Eligiblestudies were those that focused on the symptomatology ofagenesis of the corpus callosum or defect in the corpuscallosum and the respective psychiatric manifestations inhuman subjects. The citation manager used was Endnote inorder to prevent duplication of references.

Case Reports in Psychiatry 3Ta

ble1:Re

view

ofselected

literatureo

ncaseso

fpatientsthatp

resented

with

corpus

callo

sum

patholog

y.

Article

Gender

Age

Sign

sand

Symptom

sLabFind

ings/Im

agingStud

ies

Agenesis

ofCorpu

sCallosum

and

EmotionalInformationProcessin

gin

Schizoph

renia[

7]F

23

(i)ritualsof

washing

herh

ands

andclotheso

utof

fear

ofgerm

s(ii)c

ollected

issuesfrom

“People”

magazine,

predom

inantly

oftheA

merican

singer,MariahCarey

(iii)megalom

aniacald

elusio

nin

regard

toMariah

Carey,w

ithwho

msheb

elievedwas

herfrie

ndand

confi

dante

(iv)p

ersecutio

nbelief:everyone

arou

ndherw

asconspirin

gagainsth

er,w

ishingherill,resulting

inher

tofleethe

cityto

escape

herp

ersecutors

(v)v

isualdisto

rtions

andhallu

cinatio

ns

MRI

-partia

lagenesis

ofthec

orpu

scallosum,abo

vetheg

enuandsurrou

ndingthem

idlin

e,inclu

ding

the

isthm

usandanterio

rhalfo

fthe

splenium

.Lateral

ventric

lesw

erelarge,especially

poste

riorly

,extending

into

theo

ccipita

llob

e.fM

RI-m

orelateralized

and

spatially

localized

activ

ation,whenthee

motional

contento

fthe

stimuliw

asconsidered

Delu

sionalD

isorder

inaP

atient

with

Corpu

sCallosum

Agenesis

[8]

F23

(i)parano

idandpersecutoryd

elusio

nsagainsth

erbrothera

ndmother,speaking

illabou

ther

character

andconspirin

gto

killher

(ii)d

elusio

nof

reference

(iii)abusivea

ndassaultiv

e,e.g

.,started

breaking

expensiveh

ouseho

lditems

(iv)p

oora

ppetite

anddifficulty

falling

asleep,sleeping

abou

t3-4

hours

MRI

ofbrain-a

genesis

ofthec

orpu

scallosum,septum

pellu

cidu

mwith

bilateralseptalcolpo

ceph

aly

Severe

psychiatric

distu

rbance

and

abno

rmalities

ofthec

orpu

scallo

sum:reviewandcase

serie

s[5]

Pt1:F

Pt2:M

Pt3:M

Pt4:M

Pt5:M

Pt6:M

Pt7:F

Pt1:35

Pt2:29

Pt3:41

Pt4:33

Pt5:22

Pt6:12

Pt7:31

Pt1:persecutoryd

elusio

ns,aud

itory

andvisual

hallu

cinatio

ns,depression,

andthou

ghtd

isorder

Pt2:chronics

chizop

hrenia,delu

sions,tho

ught

disorder,aud

itory

andvisualhallu

cinatio

ns,and

epilepsy

Pt3:manicdepressiv

epsychosisandepilepsy

Pt4:acutea

nxiety

statewith

auditory

andvisual

hallu

cinatio

nsPt

5:schizoid

person

ality

Pt6:severe

behavioralprob

lems

Pt7:person

ality

disorder

with

depressiv

eand

conversio

nsymptom

sand

epilepsy

Pt1:CT

-lipom

ainthep

osterio

rcorpu

scallosum.E

EGperfo

rmed

twicea

tage

30;secon

dshow

edsomem

inor

dysfu

nctio

nPt

2:CT

-agenesis

ofcorpus

callo

sum,left

hemi-a

troph

yof

anterio

rhem

isphere

duetoa

CSF-containing

frontallobe

cyst,

andwidened

third

ventric

le.EEG

-abn

ormalwith

sharpwaves

over

tempo

ralregions

Pt3:CT

andMRI

-agenesis

ofthea

nteriorc

orpu

scallo

sum.E

EGs-

burstsof

generalized

rhythm

icdelta

activ

ityandleftanterio

rquadrantd

ysfunctio

nPt

4:CT

-partia

lagenesis

ofthea

nteriorc

orpu

scallo

sum.E

EGs-

norm

alPt

5:CT

-lipom

ainthes

plenium

ofthec

orpu

scallo

sum.E

EG-slowactiv

ityPt

6:CT

-partia

lagenesis

ofthec

orpu

scallosum

with

mod

erately

largelipom

a,sm

allp

oorly

defin

edcaud

ate

nuclei,and

dilatedtempo

raland

poste

riorh

orns

ofthe

third

ventric

le.EEG

-normal

Pt7:CT

-agenesis

ofthec

orpu

scallosum

andthe

lateralventriclesw

eres

eparated

byan

expand

edthird

ventric

le.EEG

was

norm

al.

Agenesis

ofcorpus

callo

sum

and

psycho

sis-reviewandcase

descrip

tion[9]

N/A

43Neuropsycho

logicalinvestig

ationrevealed

mild

mental

retardation

CTandMRI

-partia

lagenesis

ofthec

orpu

scallosum

EEG-n

ormal

4 Case Reports in Psychiatry

Table1:Con

tinued.

Article

Gender

Age

Sign

sand

Symptom

sLabFind

ings/Im

agingStud

ies

Agenesis

ofthec

orpu

scallosum

with

associated

inter-hemisp

heric

cystandrig

htfro

ntalpachygyria

presentin

gwith

psychiatric

symptom

sinaK

enyan[10]

M26

(i)depressio

nandrecurrence

ofseizures

(ii)n

ormalgeneraland

neurologicalexam

inationapart

from

somefrontallobe

signs

onmentalstatus

exam

ination

(iii)psycho

sisandlabilemoo

d

CT-a

genesis

ofthec

orpu

scallosum

with

inter-hemisp

heric

cystandrig

htfro

ntalpachygyria.N

ofatd

ensitycouldbe

identifi

edin

them

idlin

eusin

gHou

nsfield

Units.

CBC,

EEG-n

ormal

Agenesis

oftheC

orpu

sCallosum

[11]

MMiddle

Aged

(i)parano

iddelusio

ns:doctors,nursin

gsta

ff,and

patie

ntsw

erea

gainsthim

(ii)a

udito

ryhallu

cinatio

ns:voices,bo

thmalea

ndfemale,warning

him

ofthed

octors,hiswife

was

being

unfaith

ful,andhisd

eath

Imaging-a

genesis

ofthec

orpu

scallosum

Acutep

sychoticsymptom

s:a

manifesta

tionof

antip

hospho

lipid

synd

romeo

rinfarctionof

corpus

callo

sum

[12]

F25

(i)sle

eplessness,excessiv

etalking

(ii)p

ersecutory

parano

idsymptom

s(iii)auditory

hallu

cinatio

ns,com

mentary

voices

and

voices

conversin

gwith

each

other

Weigh

tedT2

MRI

-sagittalsections

show

edhyperin

tenselesions

inthes

plenium

ofthec

orpu

scallo

sum

duetoan

acuteinfarctionfro

mthrombo

sisdu

etoantip

hospho

lipid

synd

rome.

Corpu

scallosum

atroph

yand

psycho

sis:a

case

repo

rt[13]

M31

(i)delusio

nsof

persecution

MRI

-cerebralatro

phyin

thefrontop

arietalzon

e,no

n-specificg

liotic

whitematterc

hanges1,andatroph

iccorpus

callo

sum.

Neuropsycho

logicaltests(e.g.,Stroop

test,

clock-draw

ingtest)-n

ormal

Cognitiv

eimpairm

entsassociated

with

corpus

callo

sum

infarctio

n:a

tencasesstudy

[14]

10Pts:M

42-73

(i)im

pairm

ento

fmem

ory,attention,planning

,ability

tolearnnewthings,orie

ntation,

calculation,lang

uage,

andrepetition;Nopsychiatric

manifesta

tions

MRI

serie

s(T2

W1,T2

W2,FL

AIR,D

WI)-c

orpu

scallo

sum

infarctio

n

Cognitiv

e,Be

havioral,and

Psychiatric

Symptom

sinTw

oCh

ildrenwith

Agenesis

ofthe

Corpu

sCallosum:C

aseR

eport[15]

Pt1:M

Pt2:F

Pt1:11

Pt2:10

Pt1:predom

inantly

visualhallu

cinatio

nsover

auditory

hallu

cinatio

ns.A

ppearedtensea

ndconfused,w

ithspeech

impairm

ent.Lacked

insig

htandcogn

ition

.Drawings

exem

plified

thep

resenceo

fanx

ietyand

visualperceptualdelays.

Pt2:good

person

alhygiene,anxiou

s,andmostly

coherent

speech.N

odelusio

nsor

hallu

cinatio

ns.

Pt1:no

rmalneurologicalexam

ination,except

forsoft

neurologicalsig

ns.E

EG-p

resenceo

fpartia

lcom

plex

seizures.

Pt2:Psycho

logicaltestin

g-fullscaleIQ

of102,AT

RSscoreo

f28.EE

G-intermittentslowing,with

occasio

nal

high

amplitu

desharpwaves

ontheleft

occipital

region

s.Noevidence

ofclinicalseizures.M

RI-p

artia

lAC

C,predom

inantly

ther

ostrum

andtheb

ody,and

colpocephaly.

Thyroidfunctio

nstu

dies,u

rine

metabolic,aminoacid,and

organica

cidscreensw

ere

norm

al.

Develop

mentalA

bnormalities

oftheC

orpu

sCallosum

inSchizoph

renia[

16]

Pt1:M

Pt2:F

Pt1:39

Pt2:33

Pt1:visualandauditory

hallu

cinatio

ns,tellin

ghim

tokillhimself,

since

child

hood

.Pt

2:Persecutoryd

elusio

nsthatledhertoattempt

tokillherselfb

eforeh

erpersecutors“dism

embered”

her

anddisplayedhero

nthe“

John

nyCarsonSh

ow”.

Positives

ymptom

swerer

efractorytotre

atment.

Pt1:T1

weighted

MRI

-mid-sagittalim

age,almost

completea

bsence

ofthec

orpu

scallosum

Pt2:T1

weighted

MRI

-lipom

ainvolving

thee

ntire

corpus

callo

sum

Case Reports in Psychiatry 5

Table1:Con

tinued.

Article

Gender

Age

Sign

sand

Symptom

sLabFind

ings/Im

agingStud

ies

Agenesis

ofthec

orpu

scallosum

and

schizoph

renia:Acase

repo

rt[17]

M55

(i)increasin

glyirr

itablew

ithpersecutoryd

elusio

nstowards

hisp

arents

(ii)w

ithdraw

n,believedto

bepersecuted

asa

“hom

osexual”atwo

rk(iii)distr

essedby

persistentaud

itory

hallu

cinatio

nsof

several“mum

bling”

voices

which

originated

from

with

inandou

tside

hisb

ody

(iv)d

elusio

nsof

reference,believing

thatpeop

lewe

relaug

hing

andsta

ringathim,and

televisio

nprograms

referred

tohim

(v)n

odistu

rbance

oflang

uage

ormoo

d

CT-a

bsentcorpu

scallosum,m

idlin

ecystic

space

extend

ingup

wardfro

mthethird

ventric

le,and

dilated

occipitalh

orns

oflateralventricles.MRI

-com

plete

absenceo

fthe

corpus

callo

sum,present

anterio

rcommissure,andlargeC

SFfilledcavityin

theleft

frontotem

poralregion,

which

extend

stothev

ertex,

apparentlycommun

icatingwith

thev

entricular

syste

m.

Acase

ofschizoph

reniaw

ithcompletea

genesis

ofthec

orpu

scallo

sum

[18]

F24

(i)auditory

hallu

cinatio

ns,voiceso

fangelsa

ndthe

devil

(ii)e

rotic

delusio

ns,dire

cted

atam

ales

choo

lteacher

(iii)otherd

elusio

ns:losingab

abywith

everym

enstr

ual

cycle

CTandMRI

-com

pletea

genesis

ofthec

orpu

scallo

sum,w

ithcolpocephaly,

asun

burstg

yralpatte

rnandah

igh-rid

ingthird

ventric

le.

Corpu

sCallosum

Agenesis

and

Psycho

sisin

And

ermannSynd

rome

[19]

31Pts:F

31Pts:M

3-36

(i)visualhallu

cinatio

ns,persecutory

andparano

idtype,

auditory

hallu

cinatio

ns,and

parano

iddelusio

ns

Unspecifiedlab/im

agingstu

dy-4

0of

62patie

nts

presentedwith

corpus

callo

sum

agenesis,

35caseso

ftotaland

5of

partialagenesis.10of

40patie

nts

presentedwith

poste

riorfossa

atroph

y.Corpu

scallosum

shapea

lteratio

nsin

individu

alsp

riortotheo

nsetof

psycho

sis[20]

100Pts:

M&F

14-30

(i)27

outo

f100

patie

ntsd

evelop

edap

sychoticillness

T1we

ighted

MRI

-Mid-sagittalslice

show

edredu

ced

thickn

esso

fthe

anterio

rgenuof

thec

orpu

scallosum

inthe2

7symptom

aticpatie

nts

Meta-analysisof

magnetic

resonanceimagingstu

dies

ofthe

corpus

callo

sum

inschizoph

renia

[21]

MandF

10-71

(i)sig

nsandsymptom

srelated

todisordersinthe

schizoph

reniad

isorder

spectrum

orschizotypal

person

ality

disorder

MRI

-callosalareas

ofschizoph

renicp

atientso

verthe

healthyun

relatedcontrolp

atients,course

oftheilln

ess

influ

encedthes

ize

6 Case Reports in Psychiatry

Table1:Con

tinued.

Article

Gender

Age

Sign

sand

Symptom

sLabFind

ings/Im

agingStud

ies

Thec

orpu

scallosum

inschizoph

renia-volumea

ndconn

ectiv

itychangesa

ffectspecific

region

s[22]

12pts:M

12pts:F

29-49

(i)chronicp

aranoidschizoph

reniaw

hich

was

confi

rmed

with

structuredclinicalinterviews.

DTI

brainim

age-

mid-sagittalslices,corpus

callo

sum

segm

entatio

nin

3patie

nts.Vo

lumea

ndfractio

nal

aniso

tropy

were

positively

correlated

inbo

thcontrols

andpatie

nts.Fractio

nalanisotro

py,m

eandiffu

sivity,

andvolumew

eren

egatively

correlated;how

ever,all

threem

easuresw

ereh

ighlycorrelated

with

one

another.Th

ecorpu

scallosum

region

sweren

otall

affectedequally

orthes

ameb

ythea

natomicalchange.

Marchiafava-BignamiD

isease

Presentin

gas

AcuteP

sychosis[23]

M32

(i)agitatio

n,confusion,

delirium,dysarthria

,dem

entia

,psycho

ticsymptom

s,andothern

europsychiatric

manifesta

tions.

CT-h

yperdenselesionof

thec

orpu

scallosum.M

RI-

hyperin

tenselesionwith

restr

icteddiffu

sionof

the

corpus

callo

sum.

Clinicalandradiologicalfeatures

ofMarchiafava-Bignamidise

ase[24]

9pts:M

37-62

(i)behavioraldisorder,seizures,cogn

itive

impairm

ent,

delirium,dysarthria

andothern

eurologicalsym

ptom

s.

Pt1:MRI

–extend

edlesio

nsin

thes

plenium

ofthe

corpus

callo

sum.

Pt2:Pt

1:MRI

–circum

scrib

edlesio

nsin

thes

plenium

ofthec

orpu

scallosum

Pt3:Pt

1:MRI

–extend

edlesio

nsin

theg

enu,bo

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Pt5:Pt

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Pt6:Pt

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“M”,males;“F”,fem

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agnetic

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“CT”

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CC”,agenesisof

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G”,electro

enceph

alograph

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“IQ’,intelligence

quotient.

Case Reports in Psychiatry 7

Because of the rarity of agenesis of the corpus callosum,all types of studies were considered for analysis includ-ing experimental, meta-analysis, cohort, case-control, caseseries, and case reports. The pertinent information fromthe included articles was abstracted and entered into adata abstraction form using Microsoft Excel constructed bythe group. The information extracted from eligible articlesincludes the title of the article, gender and age of the patient,signs, symptoms elicited, and lab findings/imaging recorded.

A summary of the cases from the review of literature isshown in Table 1. Table 1 covers the already published cases ofpatients that presented with corpus callosum pathology andtheir respective symptoms. All the reviewed studies reportedthe gender of patients with 56 percent being male and 44percent female. The ages of the subjects ranged from 3 to 73years; the mean age was 33 years. Furthermore, out of the 15patient in the reviewed case reports and case series identifiedto have either a partial or complete agenesis of the corpuscallosum about 36 percent were female and 64 percent weremale.

Reported symptoms ranged from changes to behaviorand personality, including paranoia, hallucinations, and delu-sions, to cognitive impairment. Radiological findings of thepatients varied; however it mainly included agenesis oratrophy of the corpus callosum, followed by lipoma of thecorpus callosum.

4. Discussion

The case presented is a patient with partial agenesis ofcorpus callosum with a previous diagnosis of schizophreniaand recurrent transient loss of memory, who presentedwith mood disorder which resolved within two days duringtreatment with a combination of antidepressants and antipsy-chotics. Other probable nonpsychiatric contributors to thispresentation were ruled out in the context of normal labora-tory findings and the findings from neurologic examination.

Lesions in the corpus callosum have been implied in theetiology of psychiatric disorders; however, the pathophysio-logic mechanism is not understood. Studies have shown thatthe size or thickness of the corpus callosum area is smallerin individuals with schizophrenia when compared to thosewithout schizophrenia [20–22]. Furthermore, a defect in thecorpus callosum has been recognized in the neuropathologyfeature of some neurologic disorders which presents withpsychotic symptoms [23, 24].

Research has suggested that “asymptomatic” individualswith agenesis of corpus callosum (ACC) nevertheless haveareas of specific cognitive deficit or learning disability [4].As of yet, the pattern of consistent cognitive deficits in ACChas not been fully described. It is not clear if the partialACC in our patient contributed to his cognitive, social,and behavioral disturbances that date back to his child-hood. Results from research literature, however, suggest thathigh-functioning adults with ACC typically have moderatebut detectable deficits in the following areas: interhemi-spheric transfer of complex sensory information and learn-ing; bimanual motor coordination; complex novel problem-solving; processing of subtle phonetic and semantic aspects

of language; comprehension of second-order meanings oflanguage; and psychosocial understanding and behavior [4].

5. Conclusion

Agenesis of the corpus callosum is a rare condition thatis commonly known to be associated with seizures, devel-opmental delays in motor and language skills, and sensoryimpairment. In addition to these symptoms, there have beenmultiple findings supporting the association between ACCand neuropsychiatric manifestations such as depression,schizophrenia, bipolar disorder, learning deficits, epilepsy,and conversion symptoms. The findings from our case pre-sentation further support that there is a connection betweenACCand the onset ofmood and psychotic symptoms. Corpuscallosum anomalies interfere with the communication andregulation of activity between the two hemispheres andmanifest with these abnormal symptoms. Further studiesof mental disorders in patients with ACC are necessary toincrease our understanding and awareness of the cerebralbasis of many mental health conditions.

Consent

The patient’s consent was obtained.

Conflicts of Interest

The authors have no conflicts of interest to declare.

Authors’ Contributions

All authors have participated in the procurement of thisdocument and agree with the submitted case report.

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