Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK.
Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK
BMJ Case Rep. 2020 Dec 13;13(12):e233179. doi: 10.1136/bcr-2019-233179.
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.
边缘性脑炎常表现为癫痫发作和认知障碍,而很少出现精神科表现。在本病例报告中,我们介绍了一位 49 岁男性,他最初因精神科联络服务就诊,有几个月的意识混乱病史,并有视觉幻觉和妄想的出现。由于症状在重大经济压力源下的性质不一致,因此暂定为功能性认知障碍的诊断。进一步的检查显示电压门控钾通道 (VGKC) 抗体阳性,亚型富亮氨酸胶质瘤失活 1 型,这解释了他的症状,类固醇和免疫球蛋白治疗后症状显著缓解。这个病例强调了在出现不典型精神症状的患者中需要保持广泛的鉴别诊断。