Page 57 - JCBP-1-1

Journal of Clinical and
Basic Psychosomatics Crouzon comorbidity with psychiatric disorders

A B C

D E F

Figure 2. Imaging features: (A) “hammered silver” (beaten metal/copper beaten) pattern; (B) exophthalmos (transverse plane); (C) mild compression of
the ventricles; (D) exophthalmos (sagittal plane); (E) oval skull shape; and (F) flattened pituitary with downward position.

and 0.15 for the left eye. The adjusted vision was A B
1.2, indicating refractive errors. The degree of
exophthalmos (the shortest distance from the cornea
to the line connecting both lateral orbital rims) was
21 mm for the right eye and 23 mm for the left eye
(14.5 ± 2.35 mm for normal eyes ). The interorbital
[7]
distance was 98 mm. Fundus examination was normal
in both eyes (Figure 3). For the dental examination,
underbite, crooked teeth, crowding dentition, and
hypoplastic maxilla were reported by a dentist. In
addition, routine hematologic and biochemical tests Figure 3. Fundus examination of the (A) left and (B) right eyes.
were within normal limits, especially for thyroid
function and growth hormone.
(50 mg/day) to avoid the side effects of olanzapine due to
2.5. Diagnosis her young age and gender. Remarkably, psychotherapy and
After completing her medical and social history interview physical therapy were carried on throughout the medical
with senior psychiatrists, the girl was diagnosed with a procedure. The dental orthodontic surgery appointment
stupor. Meanwhile, CS was confirmed based on physical could not be made due to the young age of the girl until
and imaging examinations. Performing the genetic 18 years old.
confirmation without specific clinical and radiological 2.7. Outcome and follow-up
findings is acceptable .
[8]
After 2 weeks of treatment, she started to show increased
2.6. Treatment sociability and expressiveness, although she experienced
A comprehensive psychiatric treatment management was some difficulty recalling events that occurred during her
prescribed, including medication, virtual reality (VR) illness. One month after being discharge from hospital, a
physical therapy, and psychological counseling. In the follow-up was conducted through a telephone interview.
first medication treatment, olanzapine was given at a dose Her mother discontinued her use of sertraline due to
of 10 mg/night. After medication, the patient started to concerns about potential side effects. Adherence to
eat. After 1 week, she began talking with others. In the olanzapine was also poor. As a result, advice was provided
subsequent medical treatment, we changed to sertraline regarding the importance of medication adherence.

Volume 1 Issue 1 (2023) 3 https://doi.org/10.36922/jcbp.0405