CADASIL Syndrome Presenting as Obsessive-Compulsive Disorder: A Case Report

Abstract

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a small vessel disease. It is an autosomal dominant inherited disease caused by a mutation in the Notch3 gene. Clinically, it usually presents with recurrent transient ischemic attacks, strokes, vascular dementia, migraine with aura, cognitive impairments and psychiatric symptoms. Cranial MRI is the most useful imaging modality to demonstrate the characteristic radiological findings of CADASIL and gene analysis is the gold standard for diagnosis. Although the clinical manifestations are mainly neurological, CADASIL can also present with psychiatric disorders. Psychiatric disorders are one of the main clinical manifestations of the disease, with a prevalence rate rangingfrom 20 to 41%. Among psychiatric disorders, mood disorders are the most commonly reported, and other psychiatric diagnoses include psychotic disorders, anxiety disorders, adjustment disorder, personality disorders, behavioral disorders, substance dependence and abuse. In this case report, a paitent with CADASIL presenting with obsessive- compulsive disorder at a relatively young age will be presented.