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Paranoid Delusions and Cognitive Impairment Suggesting Fahr’s Disease

Received Oct. 1, 2004; revision received Jan. 28, 2005; accepted March 7, 2005. From the Department of Psychiatry and Behavioral Sciences, Davis Medical Center, University of California. Address correspondence and reprint requests to Dr. Bourgeois, Department of Psychiatry and Behavioral Sciences, Davis Medical Center, University of California, 2230 Stockton Blvd., Sacramento CA 95817; james.bourgeois{at}ucdmc.ucdavis.edu (e-mail).

The authors present the case of a 60-year-old woman with elaborate paranoid delusions and cognitive impairment found during a workup for atypical chest pain. Clinical evaluation revealed mild dementia, and radiography showed basal ganglia calcification consistent with Fahr’s disease. She was treated with risperidone and transferred to a psychiatric inpatient unit for definitive care. Psychiatrists should consider Fahr’s disease as a differential diagnosis in the evaluation of psychosis and cognitive impairment when neuroimaging reveals calcification of the basal ganglia.

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