Initial presentations of encephalitis are sometimes misdiagnosed as psychoses due to the predominance of psychiatric symptoms and frequently negative neurological work-ups. It is likely that many of these errors are never discovered. The patient described herein is an exception. Her symptoms, diagnosis, and treatment have now been followed for nearly two years and suggest not only that the initial diagnosis was in error but also that both psychiatric and organic symptoms can endure as sequelae of encephalitis. Questions regarding optimal treatment and reasons for clinical improvement are addressed.
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References
1.
HallR. C. W., Psychiatric Presentations of Medical Illness, SP Medical and Scientific Books, New York, 1980.
2.
LewisL.AllenJ. G., and FrieswykS., The Assessment of Interacting Organic and Functional Factors in a Psychiatric Population, Clinical Neuropsychology, V, pp. 65–68, 1983.
3.
RottR.HerzogS.FleischerB.WinokurA.AmsterdamJ.DysonW., and KoprowskiH.Detection of Serum Antibodies to Borna Disease Virus in Patients with Psychiatric Disorders, Science, 228, pp. 755–756, 1985.
4.
MisraP. C. and HayG. G.Encephalitis Presenting as Acute Schizophrenia, British Medical Journal, 1, pp. 532–533, 1971.
5.
RaskinD. E. and FrankS. W.Herpes Encephalitis with Catatonic Stupor, Archives of General Psychiatry, 31, pp. 544–546, 1974.
6.
WilsonL. G.Viral Encephalopathy Mimicking Functional Psychosis, American Journal of Psychiatry, 133, pp. 165–170, 1976.
7.
WellsC. E. and DuncanD. W., Neurology for Psychiatrists, F. A. Davis Company, Philadelphia, 1980.
8.
JohnsonR. T., Viral Infections of the Nervous System, Raven Press, New York, 1982.
9.
GianutsosR.Training the Short- and Long-term Recall of a Postencephalitic Amnesic, Journal of Clinical Neuropsychology, 3, pp. 143–153, 1981.
10.
CermakL. S. and O'ConnorM.The Anterograde and Retrograde Retrieval Ability of a Patient with Amnesia Due to Encephalitis, Neuropsychologia, 21, pp. 213–233, 1983.
11.
LezakM. D., Neuropsychological Assessment, Oxford University Press, New York, 1983.
12.
FreemanC. P. L. and KendellR. E.ECT I: Patients' Experiences and Attitudes, British Journal of Psychiatry, 137, pp. 8–16, 1980.
13.
FreemanC. P. L.WeeksD., and KendellR. E.ECT II: Patients Who Complain, British Journal of Psychiatry, 137, pp. 17–25, 1980.
14.
SquireL. R.WetzelC. D., and SlaterP. C.Memory Complaint after Electroconvulsive Therapy: Assessment with a New Self-rating Instrument, Biological Psychiatry, 14, pp. 791–801, 1979.
15.
WeeksD.FreemanC. P. L., and KendellR. E.ECT III: Enduring Cognitive Deficits?, British Journal of Psychiatry, 137, pp. 26–37, 1980.
16.
BeattyW. W. and RushJ. R.Spatial Working Memory in Rats: Effects of Monoaminergic Antagonists, Pharmacology, Biochemistry and Behavior, 18, pp. 7–12, 1983.
17.
OadesR. D.Impairments of Search Behavior in Rats with Haloperidol Treatment, Hippocampal, or Neocortical Damage Suggests a Mesocorticolimbic Role in Cognition, Biological Psychology, 12, pp. 77–85, 1981.
18.
ParishP., The Doctors' and Patients' Handbook of Medicines and Drugs, Alfred A. Knopf, New York, 1980.
19.
HimmelhockJ.PincusN.TuckerG., and DetreT.Sub-acute Encephalitis: Behavioral and Neurological Aspects, British Journal of Psychiatry, 116, pp. 531–538, 1970.
20.
JarvisP. E. and VollmanR. R., Beyond the Obvious: Two Cases Illustrating the Need to Consider Both Physical-Neurological and Psychosocial Factors in Assessment, Clinical Neuropsychology, V, pp. 109–111, 1983.
