A 38-year-old woman with ...

A 38-year-old woman arrived at the clinic with a one-month history of restlessness, poor sleep, auditory hallucinations of religious songs, and delusions of persecution and reference. During her pregnancies (8 and 11 years ago), she experienced postpartum psychosis, necessitating inpatient treatment with antipsychotics and mood stabilisers. She stopped receiving treatment both times after becoming better and did not suffer any symptom recurrence until the present episode. She had no substantial family history or additional comorbidities. Cavum vergae (CV, figure A)) was seen in a brain MRI diffusion-weighted imaging sequence, and a brain MRI apparent diffusion coefficient sequence showed CV and a narrowed cavum septum pellucidum (CSP, figure B). Treatment was initiated accordingly. At the 6-month mark, delusions returned when the medicine dosage was reduced, but when the dosage remained the same, there were no symptoms.1