Advertisement

An Abrupt Change in Mental Status

  • Hazar Khidir
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts

    Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    Search for articles by this author
  • Benjamin A. White
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
    Search for articles by this author
  • Adaira Landry
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    Search for articles by this author
  • Amy A. Cameron
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
    Search for articles by this author
  • Kathleen Wittels
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
    Search for articles by this author
  • Susan R. Wilcox
    Correspondence
    Reprint Address: Susan R. Wilcox, MD. Department of Emergency Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.
    Affiliations
    Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts

    Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
    Search for articles by this author
      Dr. Hazar Khidir: Today's case is that of a 35-year-old woman brought to the Emergency Department (ED) for evaluation of altered mental status. She was brought in by her partner, who provided the entirety of the initial history, given her altered mental status. Per her partner, she did not have any preceding medical history and was a full-time graduate student. Her symptoms started 5 days prior to presentation when she complained of muscle pain, a mild headache, and nausea. Later that evening, she also developed a fever to 38.3°C (101°F). She continued to have muscle pain and headache intermittently over the subsequent 3 days.
      To read this article in full you will need to make a payment

      References

        • Venkatesan A
        • Tunkel AR
        • Block KC
        • et al.
        Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium.
        Clin Infect Dis. 2013; 57: 1114-1128
        • Esposito S
        • Principi N
        • Calabresi P
        • Rigante D.
        An evolving redefinition of autoimmune encephalitis.
        Autoimmun Rev. 2019; 18: 155-163
        • Graus F
        • Titulaer MJ
        • Balu R
        • et al.
        A clinical approach to diagnosis of autoimmune encephalitis.
        Lancet Neurol. 2016; 15: 391-404
        • Vora NM
        • Holman RC
        • Mehal JM
        • Steiner CA
        • Blanton J
        • Sejvar J.
        Burden of encephalitis-associated hospitalizations in the United States, 1998–2010.
        Neurology. 2014; 82: 443-451
        • Lancaster E.
        The diagnosis and treatment of autoimmune encephalitis.
        J Clin Neurol. 2016; 12: 1-13