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SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
A patient with an acute confusional state.
Graham Baker1, Maurice Jackson, Sanjay Vydianath
1Department of Medicine, The Royal Wolverhampton NHS Trust, Wolverhampton, UK. grahambaker@doctors.org.uk
BMJ Case Reports
|July 17, 2012
Summary
A rare cause of acute confusion, limbic encephalitis, was diagnosed in a middle-aged man. Prompt treatment with immunoglobulin led to significant recovery, highlighting its treatable nature.
Area of Science:
- Neurology
- Immunology
Background:
- Limbic encephalitis is an inflammatory condition affecting the brain's limbic system.
- Acute confusion can be a presenting symptom, necessitating a thorough diagnostic workup.
Observation:
- A 49-year-old male presented with acute confusion, with initial examinations and blood tests being unremarkable.
- MRI brain scan revealed changes consistent with limbic encephalitis.
Findings:
- Despite negative antibody and malignancy screening (including para-neoplastic auto-antibodies and CT scans), the patient responded well to intravenous immunoglobulin therapy.
- Follow-up imaging demonstrated significant radiological improvement, and the patient returned to work.
Implications:
- This case underscores the importance of considering limbic encephalitis in patients presenting with acute confusion, particularly in middle-aged individuals.
- Early diagnosis and treatment with immunomodulatory therapies can lead to favorable outcomes and recovery.
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