Split brain Syndrome: A case manager's intervention

This article presents a case report of the challenges and management plans of a client whose MRI scan presented with partial agenesis of the corpus callosum (CC) also known as a split brain syndrome. The Early Psychosis... [ view full abstract ]

This article presents a case report of the challenges and management plans of a client whose MRI scan presented with partial agenesis of the corpus callosum (CC) also known as a split brain syndrome. The Early Psychosis Intervention Program (EPIP) accepted the client into their service with an initial diagnosis of Attenuated Psychosis Syndrome or a differential of Delusional disorder, given her strong family history of Schizophrenia.   

The 33 year old Chinese lady, eldest of 3 children has a tertiary education in Journalism unlike many others with CC agenesis who have difficulty completing their education given their cognitive deficits. She is currently not on any medications as her psychotic symptoms are not prominent and she has been managed through various therapeutic interventions.

She has accused family of emotionally and physically abusing her.  Placement of client in a step down facility and accommodation was presented with challenges given her poor relationship with people and her interpersonal conflicts. She has difficulties with higher level thinking such as abstract reasoning and problem solving. She also presents with difficulties in identifying, describing and managing her emotions. Her lack of empathy has led her to make harsh “unfiltered” remarks about others which have affected her social functioning. 

A missing Corpus Callosum and the resultant deficits has posed a great challenge in her social skills. Her emotional immaturity, lack of self-awareness of deficits, impaired social competence and deficits in social judgement has required constant implementation of active alternative strategies in her case management. Intensive hand holding to minimise misconstruing of meanings was also employed.  It has been a constant work in progress for the Case Manger’s efforts in searching for alternative perspectives in aiding her towards better functioning whilst monitoring the psychotic symptoms.