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BMJ Case Rep ; 13(12)2020 Dec 13.
Article in English | MEDLINE | ID: mdl-33318259

ABSTRACT

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.


Subject(s)
Autoantibodies/blood , Cognitive Dysfunction/etiology , Limbic Encephalitis/diagnosis , Limbic Encephalitis/psychology , Potassium Channels, Voltage-Gated/immunology , Anti-Inflammatory Agents/therapeutic use , Confusion/etiology , Delusions/etiology , Diagnosis, Differential , Hallucinations/etiology , Humans , Immunoglobulins, Intravenous/therapeutic use , Limbic Encephalitis/drug therapy , Male , Methylprednisolone/therapeutic use , Middle Aged
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