A mexican werewolf in barcelona: clinical lycanthropy due to cerebellar lesion and hydrocephalus.

Introduction: Clinical lycanthropy is an uncommon delusion of turning into a wolf. A systematic review in 2016 found only 13 case descriptions, only one not secondary to a psychiatric disorder. Objectives: To identify and describe an unusual symptom based on a clinical case. Methods: The present study is a case report of a patient admitted for clinical lycanthropy to our hospital. Wealso searched previously case reports, series and systematic reviews of clinical lycanthropy using a pubmed query ("lycanthropy", "cerebellum", "hydrocephalus", "psychosis"). Results: Mr. CJ. is a 38-year-old Mexican male, with no prior psychiatric history or substance use. He was admitted for bizarre behaviors and delusions. He had been living in the forest for the last weeks with the belief that he was a werewolf, and on full moon he behaved like a wolf (naked and howling). He also presented multimodal hallucinations, headache, ataxia and visual blur. The mental evaluation did not suggest a delirium. A CT scan revealed a left cerebellar lesion and hydrocephalus (Image 1,2,3). He experienced full remission of psychotic symptoms after external ventricular drain and antipsychotic treatment (risperidone, olanzapine). After surgical r emoval the histology revealed a cerebellar hemangioblastoma. Conclusions: The clinical presentation suggested the diagnosis of a psychotic disorder due to cerebellar hemangioblastoma with consequent hydrocephalus. Cerebellum abnormalities and hydrocephalus have been associated to psychotic symptoms. Furthermore, other case reports showed rapid recovery of psychosis due to hydrocephalus after neurosurgical intervention. To our knowledge, this is the first report about clinical lycanthropy due to a tumor of the central nervous system. [ABSTRACT FROM AUTHOR]