The Clinical Problem Solvers Episode 395: Neurology VMR – Behavior change, headaches, and blurry vision
May 9, 2025
Aye Chan Moe Thant, a medical graduate from Myanmar, joins the discussion to present a challenging case of a 51-year-old woman with behavioral changes, headaches, and blurry vision. They delve into diagnosing complex neuroimmune disorders and explore potential diagnoses like hydrocephalus and encephalitis. The conversation highlights the role of environmental factors and intra-cranial pressure symptoms, emphasizing the importance of thorough clinical evaluations and imaging. Aye's commitment to health equity adds a powerful dimension to the medical intricacies discussed.
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Localization and Time in Behavior Change
- Behavioral changes localize mostly to the frontal and limbic brain regions.
- Time course helps differentiate causes: acute infections versus subacute immune, toxic, or mass lesions.
History Keys for Behavior Change
- Always clarify the specific behavioral change type and time course from history.
- Screen for seizures, movement, or headaches as red flags for immune-related causes.
When to Suspect Immune Encephalitis
- Consider immune-mediated encephalitis if psychiatric symptoms evolve with seizures or movement disorders.
- Consult psychiatrists to detect atypical presentations and avoid dismissing organic causes as purely psychiatric.
