PT - JOURNAL ARTICLE AU - Eric Garrels AU - Fawziya Huq AU - Gavin McKay TI - Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment AID - 10.1136/bcr-2019-233179 DP - 2020 Dec 01 TA - BMJ Case Reports PG - e233179 VI - 13 IP - 12 4099 - http://casereports.bmj.com/content/13/12/e233179.short 4100 - http://casereports.bmj.com/content/13/12/e233179.full SO - BMJ Case Reports2020 Dec 01; 13 AB - 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.