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VGKC‐complex antibody mediated encephalitis presenting with psychiatric features and neuroleptic malignant syndrome – further expanding the phenotype
Author(s) -
Iyer Anand,
Mc Tague Amy,
Curran Andrew,
Inbasagaran Anandhi,
Vincent Angela,
Kneen Rachel
Publication year - 2012
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2012.04249.x
Subject(s) - limbic encephalitis , neuroleptic malignant syndrome , catatonia , pediatrics , encephalopathy , medicine , psychomotor agitation , encephalitis , psychiatry , psychology , akathisia , antipsychotic , schizophrenia (object oriented programming) , virus , virology
reports, the clinical spectrum of VGKC-complex antibody mediated neurological conditions is widening and now includes limbic encephalitis, fever-induced refractory encephalopathy, and early-onset epileptic encephalopathy. We have also treated a child with VGKC limbic encephalitis with some different and additional features. Written consent for publication was obtained from the parents. A 13-year-old female with moderate learning difficulties presented with a gradual onset personality change, reduced and repetitive speech content, altered sleep pattern, and episodic extreme agitation following a flu-like illness. Examination revealed no neurological signs except a slight tremor of the hands and intermittent extreme agitation. During brief periods of alertness (lasting a few minutes at a time only), she could talk, eat, drink, and walk. She was initially referred to the child psychiatry team (Alder Hey Children’s Hospital), diagnosed with severe, agitated depression, and treated with fluoxetine and risperidone. She subsequently developed features consistent with neuroleptic malignant syndrome (NMS) requiring treatment with hydration, amantadine, and withdrawal of neuroleptics.