Psychosis as Primary Presentation of Neurological Disorders

Psychosis can be a primary manifestation of various neurological disorders, often leading to misdiagnosis and inappropriate treatment. This case series highlights the importance of recognizing psychosis as a potential presentation of underlying neurological conditions, particularly in patients with unusual or resistant psychiatric symptoms. We present five cases where psychosis was the primary symptom of conditions: leukodystrophy, tuberous sclerosis, meningioma, subacute subdural hemorrhage, and anti-N-Methyl-D-Aspartate (anti-NMDA) receptor encephalitis. Early recognition, appropriate imaging, and neurological consultation were crucial in diagnosing and managing these conditions, resulting in a better prognosis for patients. This case series emphasizes the need for a high index of suspicion, particularly when patients present with atypical psychiatric symptoms along with neurological findings.