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Neuropsychiatric case vignettts  

Case 1
MC is a 23 years old Caucasian man who was first diagnosed with OCD following his first admission in 2001. Later that year diagnosis was changed to Schizophrenia. He displayed catatonic (stereotypies, waxy flexibility etc) and hebephrenic features and proved to be treatment resistant. In the last month he became increasingly withdrawn, and was “freezing” during the conversations and tasks. He showed worsening of catatonia. Following further assessment and investigations he showed evidence of EEG and MRI changes consistent with cerebral vasculitis requiring change in the treatment.

Case 2
AE is a 20-year-old girl who was referred by her Neurologist with a 3-year history of increasing pain, disability, and weakness. She had a recent onset of fits. Results of EEG and MRI were normal. She showed evidence of Non-epileptic fits following the neuropsychiatry assessment. Further management in conjunction with Neurologist including joint consultations prevented the need for expensive telemetry and prolonged hospital stay.

Case 3
FSD is a 52-year-old IT professional who presented with a 3-year history of decline in his memory, organisational skills, judgement and functioning. Neurologists extensively investigated him with no definite diagnosis. He showed evidence of psychosocial problems and anxiety and depressive symptoms, which partially contributed, to his early onset dementia but despite adequate treatment of the psychological issues he showed only partial improvement. This confirmed a diagnosis of early onset frontal lobe dementia.

Case 4
Mr WD is a 38-year-old nurse who developed Cerebral Sarcoidosis with discrete lesions in the cortex and subsequently presented with recurrent manic episodes. The manic episodes proved to be resistant to treatment, and were made worse by treatment for Sarcoidosis. His ongoing management involved regular communication with neurologist and constant titration of his neurological and Neuropsychiatric medications preventing unnecessary psychiatric or neurological admissions.