Atypical presentation of prosopometamorphopsia in concurrent postpartum mood disorder and bipolar II disorder: a case report

Ellie Rapp; Aditi Pajiyar; Luis Rodriguiez; Himani J. Suthar; Arushi Chandra Parikh; Parinda Parikh

doi:10.18203/2320-6012.ijrms20261706

Authors

Ellie Rapp College of Arts and Sciences, Case Western Reserve University, Cleveland, USA
Aditi Pajiyar Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
Luis Rodriguiez Universidad de Ciencias Médicas de La Habana, Havana, Cuba
Himani J. Suthar Department of Psychiatry, G.M.E.R.S. Medical College and Civil Hospital, Gandhinagar, India
Arushi Chandra Parikh Steinhardt School of Culture, Education, and Human Development, New York University, New York, USA
Parinda Parikh Brooklyn Hospital Center, Brooklyn, USA

DOI:

https://doi.org/10.18203/2320-6012.ijrms20261706

Keywords:

Prosopometamorphopsia, Bipolar II disorder, Pituitary adenoma, Postpartum mood disturbance

Abstract

Women are at an increased risk of being diagnosed with bipolar II disorder, and bodily fluctuations related to pregnancy can significantly alter the severity of symptoms. Hormonal changes may warrant severe perinatal and postpartum mood disturbances in this population and lead to the development of symptoms related to psychosis, such as visual hallucinations. Prosopometamorphopsia is a rare disorder related to the visual perception of faces. While it is most commonly attributed to organic neurological causes like tumors, some cases of prosopometamorphopsia have been linked to mood or psychotic disorders. A 38-year-old female diagnosed with bipolar II disorder and postpartum mood disturbance reported paranoia and symptoms of prosopometamorphopsia beginning in mid-pregnancy and continuing multiple months postpartum. MRI suggested the presence of a pituitary microadenoma. This case describes the atypical presentation of an extremely rare visual perception condition concurrent with postpartum mood disturbance and bipolar II disorder, possibly related to the presence of a pituitary adenoma. Though literature has reported instances of visual hallucinations stemming from pituitary adenoma, the etiology of the patient’s perceptual issues is unclear. Despite a lack of patient background and relevant research findings, this unique case prompts further exploration of potential neurobiological and hormonal connections among pituitary adenoma, perinatal/postpartum mood disturbance, and prosopometamorphopsia.

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