CADASIL Syndrome Presenting as Adjustment Disorder

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), usually referred to as CADASIL, is an inherited autosomal dominant condition that can cause stroke, dementia and other neurological impairments. Clinically, it presents most frequently as neurogical disturbances, although psychiatric symptoms may also be seen in about 20%-41% of cases. Psychiatric disturbances encountered most often in CADASIL include mood and adjustment disorders, particularly depression. In this case report, we highlight a patient with CADASIL syndrome, who had adjustment disorder with neurological signs appearing only later, leading to diagnosis of CADASIL. Treatment of the condition and patient follow-up are also discussed below.