Atypical affective disorder with episodic dyscontrol: a case of von Economo's disease (encephalitis lethargica)

The case is described of a patient with atypical affective disorder, episodic behavioural dyscontrol and parkinsonism resulting from presumed encephalitis lethargica. EEG abnormalities were found which were compatible with a post-encephalitic state and suggestive of epileptiform complications. Poor or deleterious response to neuroleptics, sleep disorder, and parkinsonism are features that may allow recognition of this illness in a psychiatric setting.