Book contents
- Common Pitfalls in Cognitive and Behavioral Neurology
- Common Pitfalls in Cognitive and Behavioral Neurology
- Copyright page
- Dedication
- Contents
- Diseases Discussed in the Book
- Preface
- Acknowledgements
- Abbreviations
- Part 1 Missing the Diagnosis Altogether
- Part 2 Misidentifying the Impaired Cognitive Domain
- Part 3 Missing Important Clues in the History
- Part 4 Failure of Pattern Recognition
- Part 5 Difficult-to-Characterize Cognitive/Behavioral Disorders
- Part 6 Clinical Findings That Are Subtle
- Part 7 Misinterpreting Test Results
- Case 31 Does a Positive Amyloid Scan Always Mean Alzheimer Disease?
- Case 32 Herpes Encephalitis Recurrence?
- Case 33 Refractory “VGKC Encephalopathy”
- Case 34 sCJD with Negative 14–3–3?
- Case 35 You Have Been Diagnosed with Alzheimer Disease; Is That It?
- Part 8 Attributing Findings to a Known or Suspected Disorder
- Part 9 Missing Radiographic Clues
- Part 10 Management Misadventures
- Index
- Plate Section (PDF Only)
- References
Case 33 - Refractory “VGKC Encephalopathy”
from Part 7 - Misinterpreting Test Results
Published online by Cambridge University Press: 03 November 2020
- Common Pitfalls in Cognitive and Behavioral Neurology
- Common Pitfalls in Cognitive and Behavioral Neurology
- Copyright page
- Dedication
- Contents
- Diseases Discussed in the Book
- Preface
- Acknowledgements
- Abbreviations
- Part 1 Missing the Diagnosis Altogether
- Part 2 Misidentifying the Impaired Cognitive Domain
- Part 3 Missing Important Clues in the History
- Part 4 Failure of Pattern Recognition
- Part 5 Difficult-to-Characterize Cognitive/Behavioral Disorders
- Part 6 Clinical Findings That Are Subtle
- Part 7 Misinterpreting Test Results
- Case 31 Does a Positive Amyloid Scan Always Mean Alzheimer Disease?
- Case 32 Herpes Encephalitis Recurrence?
- Case 33 Refractory “VGKC Encephalopathy”
- Case 34 sCJD with Negative 14–3–3?
- Case 35 You Have Been Diagnosed with Alzheimer Disease; Is That It?
- Part 8 Attributing Findings to a Known or Suspected Disorder
- Part 9 Missing Radiographic Clues
- Part 10 Management Misadventures
- Index
- Plate Section (PDF Only)
- References
Summary
This 72-year-old left-handed woman presented with a 2-year history of worsening cognitive slowness. Her family first noticed she had difficulties multitasking and was slower to respond. She progressively became forgetful and exhibited episodes, some characterized unintelligible speech, while in other she appeared to be in a daze. Her gait slowed down in the last year and she now walked with a stooped posture, dragging her feet. In addition, her family endorsed anosmia and dream enactment behavior during the review of systems. She had been evaluated for a possible autoimmune/paraneoplastic encephalopathy due to the relatively rapid progression of his symptoms. He was found to have elevated titers of voltage-gate potassium channel complex (VGKCC) antibodies (0.08 nmol/L; normal < 0.02). Leucine-rich glioma inactivated 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) were negative. Given this finding, he underwent a five-day course of intravenous immunoglobulin (IVIg), without subjective or objective (i.e., cognitive testing) improvement.
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- Common Pitfalls in Cognitive and Behavioral NeurologyA Case-Based Approach, pp. 104 - 106Publisher: Cambridge University PressPrint publication year: 2020