INTERMITTENT DYSLEXIA IN
AN YOUNG ADULT WITH INITIAL INSOMNIA, DYSLALIAS AND HEADACHE. RESULTS OF A
FOUR-MONTHS TREATMENT WITH ANTISTRESS AND ANTIDEPRESSANTS DRUGS.
Renato Cocchi, neurologist and medical
psychologist.
Summary
A case of intermittent dyslexia in a
university student of 23 years, with initial insomnia, dyslalias and headache,
is reported.
In his remote history there was a
provoked delivery to 36 weeks, with help of vacuum extractor and forceps, and
pathological hyperbilirubinemia, treated with UV.
A therapy with antistress and
antidepressant drugs lasting four months has allowed a general improvement and
a clear reduction of the dyslexia.
Key words: Dyslexia, stress, depression,
dyslalia, headache, therapy, drugs.
Drug modulation of stress reactions
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After many years from the preceding case
(Cocchi, 1990) it came to my observation a case of intermittent dyslexia in a
young adult with other relatively important troubles. I shall report it after
four months from the beginning of a low dosing antistress and antidepressant
therapy.
The case.
Male, of 23 years at first consultation, a
university student. He asked my help for dyslexia problems occurring to nearly
alternate day.
Following a fall of his mother in the 36th
pregnancy week, the amniotic sack was broken. For which the obstetrician
induced the delivery by drugs, and extraction with vacuum extractor and
forceps. His weigh at the birth, was 2600 grams. In the second day of life he
developed pathological high blood bilirubine, treated with UV.
In his first year of life he ate much, slept
normally, without any problem of intestinal emptying, he was pale, had easiness
to upper respiratory tract infections, but he did not cry for no reason.
He had ambidextrousness troubles, and he was
always much sensitive. As a child he fainted to the sight of the blood. He has
done a school of art.
04 October 2003. The dyslexia is the usual type,
with semantic substitutions, letters transposition and some false recognition
among graphically similar letters, but otherwise placed into the space.
Besides it, there are a. serious initial
insomnia (not falling asleep before the 2-3 AM), b. dyslalias, c. neck or
frontal headache, d. marked opposition answers. To the test "Say me the
opposite of the colour Red", he answers: White. He says that he thinks too
much, and that he has concentration difficulties when studying.
Usually, he is normally liking sweet things,
but not the meat or the cube broth, drinks 3-5 cups of coffee every day. He
does not stand the cold. In the morning he is slowing, irritable, and confused.
He does not have breakfast before 10-11 AM. He bears badly the light. At night,
he talks during his sleep, has drooling, but not muscular cramps, no bruxism.
When awakes, he cannot remember his dreams. Now, he worries for the loss of his
hair.
Trial therapy (daily doses, by the oral
via): Glutamine 250mg; pyridoxine 75mg; carbamazepine 100mg; amitriptyline 8mg;
oxazepam 7.5mg.
24 November 2003. Now he is doing little
best. He succeeds to sleep about midnight. Drooling during the sleep stopped.
He doesn't know if he talks during his sleeping. He had some tarnishing moments
of his sight [low blood tension?]. The dyslexia did not low. Perhaps he has
suffered from fewer headaches, but he is hypersensitive as first. If he isn't
in a hurry because he must go to the university, he succeeds to have breakfast.
Now he bears better the light. The threshold of the cool did not vary. He feels
less confused, less slowed and less irritable in the mornings. Perhaps he has
his head less full of thoughts, with less dyslalias. Her hair is less fat.
Therapeutic variation (daily doses, by the
oral via): Carbamazepine 200mg; oxazepam 15mg; amitriptyline 12mg.
23 February 2004. (The patient himself
evaluated his symptoms as percentage rates). He is doing altogether well. The
hair doesn't fall anymore. Although he is even dyslexic, which is only 30-40%
of the initial situation. Initial insomnia went off. He does always labour to
get up in the mornings, where he has dyslalia or difficulty in emitting the
first word.
Less opposition answers. Now he bears well
the light. No drooling during his sleep (an episode in three months). His head
is less full of thoughts and he improved the concentration ability from 0
initial to 45%. Tarnishing of the sight disappeared, and some headache came out
only in weekends. His emotional threshold went up from 0 initial to 30%.
The early-morning slowing improved a few:
from 0 initial to 10%. Early-morning irritability diminished from 100 to 60%.
He says that he is suffering less from the cool, but he continues to wear heavy
clothes.
Therapeutic variation (by the oral via, in
daily doses): Amitriptyline 4mg.
Discussion.
In the dyslexia we know a male prevalence
and the fact that the trouble of the reading can be brought in adult age
(DSM-IV, 1994). The novelty of this case is the intermittent feature of the
trouble. This fact suggests that we deal, at least here, of a functional
problem, linked to a low tolerance threshold to the stress of any origin, even
meteorological one. They bring towards the same hypothesis the low emotional
tolerance threshold, that for the light, that with the cold and the perinatal
suffering, with reduction of the hippocampus-suprarenal feedback even in course
( Sapolsky 1990; 2000; 2001)
The serious initial insomnia and the
headaches, mainly the frontal one, suggested a masked depression.
The ambidextrousness in past; the groundless
opposition; the White as answer to the test "Say me the opposite of the
colour Red,"; all three point up for problems of half-brain dominance, at
least for some functions.
I found the head blocked by thoughts and the
difficulty of concentration in students who stop examinations or abandon the
studies (Cocchi 1994; 1995; 2003; 2004).
But now, I cannot correlate them to a some
neuropsychological or neurochemical mechanism, even if I think them in the
range of stress reactions.
Owing to my poor experience as for the
dyslexia, I will try only a comparison with the other case I treated by drugs
(Cocchi, 1990).
In both cases there was a perinatal
suffering, more heavy in the first case, who had a brain haemorrhage and
convulsions in the second day of life.
Both cases had depressive aspects, evident
in the child, masked in this last young adult.
The dyslexia started to surrender following
enough similar drug therapies, as antistress and antidepressant for both: After
five months in the child, after four months in the university student, who has
already intermittent dyslexia.
Of course, by trying to modulate stress
answers by drugs implies a tailored therapy, because each person has different
stress answers, for genetic and acquired constitutional reasons.
Bibliografia
American Psychiatric Ass. DSM-IV Diagnotic
and Statistic Manual of Mental Disorders, Fourth Edition. APA, Washington DC
1994.
Cocchi R. Un caso di dislessia in eta`
scolare trattato con farmaci per 44 mesi. Riv. It. Disturbo Intellet. 1990, 3:
159-165.
Cocchi R. Problems of attention and
concentration leading to interruption of studying by high school and University
students: A report of 4 cases. It. J. Intellect. Impair. 1994, 7: 29-38.
Cocchi R. Scientific college dropouts and
the risk for psychotic outcome: Four male cases. It. J. Intellect. Impair.
1995:, 8: 37-43.
Cocchi R. The trouble of the concentration,
and stop studying in three university students. Relief after antistress drug
therapy. Posted on Internet on July 2003.<www.stress-cocchi.net/Droping3.htm>
Cocchi R. Deficit di concentrazione e
ritardo accademico in una studentessa universitaria con caratteristiche
neuropsichiatriche particolari. Posted on Internet on January
2004.<www.stress-cocchi.net/Droping4.htm>
Sapolsky RM. Glucocorticoids, hippocampal
damage and the glutamatergic synapse. Prog Brain Res (Netherlands), 1990, 86:
13-23.
Sapolsky RM. Glucocorticoids and hippocampal
atrophy in neuropsychiatric disorders. Arch Gen Psychiatry (United States),
2000, 57: 925-935.
Sapolsky RM. Depression, antidepressants,
and the shrinking hippocampus. Proc Natl Acad Sci U S A (United States), 2001,
98: 12320-12322.
Posted on Internet on February 2004.
Copyright by Renato Cocchi, 2004.
Author's address: dr Renato
COCCHI, via Rabbeno, 3
42100 Reggio Emilia (Italy)
renatococchi@libero.it
Drug modulation of stress reactions
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