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Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment
  1. Eric Garrels,
  2. Fawziya Huq and
  3. Gavin McKay
  1. Psychiatric Liaison Service (Queen's Hospital), NELFT NHS Foundation Trust, Romford, Essex, UK
  1. Correspondence to Dr Gavin McKay; gavin.mckay{at}


Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

  • memory disorders
  • delirium
  • epilepsy and seizures
  • somatoform disorders

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  • Contributors FH and GM were involved in the clinical care of this case and conception of the case report. EG performed the substantive literature review and first draft. All authors then contributed to redrafting and final approval of the submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.