agenesis of corpus callosum ( acc ) is mostly a congenital anomaly that occurs predominantly in males , either isolated or in combination with other cns or systemic malformations . corpus callosum develops from the lamina reuniens in the telencephalon and begins to appear at around 10.5 weeks , till it reaches adult form by 17 weeks . disturbance of embryogenesis in the first trimester of pregnancy by an unknown insult is sometimes put forward as a probable antenatal cause . once thought to be a rare condition , acc has been turning up with increasing frequency ever since the widespread clinical use of mri . acc can occur in other congenital anomalies , including arnold - chiari malformation , dandy - walker syndrome , schizencephaly ( clefts in brain tissue ) and holoprosencephaly ( failure of the forebrain to divide into lobes ) , aicardi 's syndrome , fetal alcohol syndrome and several trisomies . acc can also be associated with malformations in other parts of the body , such as midline facial defects , or can occur as one of the developmental abnormalities in schizophrenia . the effects of the disorder range from subtle to severe , depending on associated brain abnormalities . but children with the most severe brain malformations may have intellectual disability , seizures , hydrocephalus and spasticity . depressive spectrum disorders have been mentioned in various literatures to be present with this anomaly , but recurrent brief depression has not been mentioned in any of them . this congenital anomaly has also been found in bipolar disorder , schizophrenia and can interfere with psychomotor development . in addition , individuals with acc are reported to have more sensory deficits and abnormalities , as well as altered patterns of feeding / eating , elimination and sleep . a 25-year - old man residing in a suburban region was brought to the psychiatry opd at the tertiary care hospital with biparietal dull - aching headache lasting for about an hour , occurring 3 to 4 times per month for the past 2 years . the headache , to start with , was spontaneous in onset , without nausea or vomiting , diurnal variation , fever , photophobia , phonophobia , and subsided with analgesics tablet ibuprofen 400 mg only . he had been prescribed tab flunarizine 10 mg od and amitriptyline 25 mg od for the last 1 year . on careful history - taking from the informant ( father ) and the patient himself , it was known that the patient had suffered from episodes of depressed mood and irritability every month lasting for 3 to 7 days on an average , diminished interest in pleasurable activities , hypersomnia , psychomotor retardation , fatigue and loss of energy for the past 1 year with recurrent thoughts of death but without any history of suicidal attempt so far . there was no positive family history of any major medical or psychiatric illnesses in the family up to three generations . he had been advised to have a ct scan followed by an mri of brain for the persistent headache , 1 month back . also there was a history of palpitation , breathlessness , clenching of teeth followed by unresponsiveness , each episode lasting for 30 minutes to 1 hour , four times in the past 2 weeks . there had been no tongue bite , incontinence , loss of consciousness during the episodes , and the patient was occasionally verbalizing during these periods . he had been brought to the emergency room 1 week back by his family members and neighbors in a state of unresponsiveness . the reported symptoms had lasted for 2 hours , along with jerky movements of all four limbs and clenching of teeth but without any injury , incontinence or fall . according to his parents , he was able to adjust his body parts when placed in awkward position during these periods of unresponsiveness . after gaining consciousness , he refused to talk or answer but tried to use gestures and sign languages to answer questions asked to him . he had a fall when he was asked to walk a few steps , but the fall was guarded without any injury . during mental status examination ( mse ) , the patient was found to be guarded initially , with increased reaction time , monotonous speech and depressed affect . he suddenly had an attack mimicking a swooning attack in the presence of his family members while the interview was in progress , which subsided on negative reinforcements and suggestions . there were no clinical features suggestive of an epileptic seizure , which was confirmed by routine eeg and subsequently by video - eeg . agenesis of corpus callosum is a rare condition ( with us frequency rates reported to be 0.07% to 5.3% ) which usually presents with clinical features such as seizures , feeding problems , developmental delay , impaired hand - eye coordination , impaired visual and auditory memory and hydrocephalus . in this patient , there were few delayed milestones of development only without any gross physical or mental disability . the uniqueness of the case was that it presented with recurrent depressive disorder with swooning attacks . the patient responded well to a trial of benzodiazepines ( clonazepam ) followed by maintenance with ssris . the diagnosis has been done on the basis of appendix b of the diagnostic and statistical manual of mental disorders ( dsm - iv - tr ) , which includes criteria and axes provided for further study . the diagnosis remained stable on subsequent follow - up visits and did not turn out to be any other major mood disorders . though the condition can have wide range of manifestations , in our case we noticed only recurrent brief depression de novo and conversion disorder as a consequence of reaction when the diagnosis was disclosed to the patient . he never met the criteria of major depressive disorder during the entire period of his illness . the clinical manifestations of callosal agenesis can be described under two headings , viz . , nonsyndromic forms are the most common . an unknown , though probably small , proportion of patients are completely asymptomatic , or more commonly , their condition is incidentally discovered during neuroimaging . the recurrent brief depression is an entity mentioned in icd-10 ( international classification of mental and behavioral disorders ) in the section of other recurrent mood ( affective ) disorders ( f 38.10 ) . the dsm - iv - tr demands further study to formulate a more valid diagnosis of this entity . the questions of stability and validity of its diagnosis are always there since its nosology . in this case , it has been diagnosed with another rare congenital cns anomaly , the agenesis of corpus callosum ( acc ) . psychiatric antecedents and comorbidities in agenesis of corpus callosum ( acc ) need to be explored more in future case reports . similarly comorbid general medical conditions need to be studied for getting more information on the diagnosis of recurrent brief depressive disorder . contrast - enhanced ct scan showing parallel ventricles with continuation of interhemispheric fissure with the third ventricle ; however , there was no evidence of any interhemispheric cyst axial t1 mri showing prominent interdigitations of gyri the sagittal t1 image in this patient showing absent anterior genu and splenium . there were also dilatations of the atrium and occipital horn ( colpocephaly ) coronal t2 mri of the patient showing agenesis of corpus callosum with parallel lateral ventricles the sagittal sections of the t2-weighed imaging replicating earlier findings
agenesis of corpus callosum can have various neuropsychiatric manifestations . following 
 case report highlights the case of a young man presenting with features of recurrent brief depressive disorder , each lasting for about 3 to 7 days , for over a year . 
 he had history of occasional headache and episodes of swooning attack in between , usually precipitated by emotional events . 
 his neuroimaging revealed agenesis of corpus callosum . 
 he was experiencing swooning attacks as he became aware that some  unusual findings were present in his reports . 
 recurrent brief depression can be a manifestation of this congenital anomaly , and conversion disorder can be present as comorbid diagnosis perhaps due to ignorance and fear of this apparently innocuous congenital malformation .