Practical Neurology

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Practical Neurology 2003;3:36-39; doi:10.1046/j.1474-7766.2003.00090.x
Copyright © 2003 by the BMJ Publishing Group Ltd.

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Clinicopathological Conference

Cognitive Decline, Behavioural Disturbance and Motor Dysfunction in a Young Adult

A. F. A. Merrison*, T. H. Moss{dagger}, R. Feller{ddagger}, N. J. Scolding*

* Institute of Clincal Neurosciences, Departments of Neurology and
{dagger} Neuropathology, Frenchay Hospital, Bristol, and
{ddagger} Learning Disability Service, Beaver House, 147–150 Victoria Road, Swindon, UK

EXTRACT

CLINICAL HISTORY

A 29-year-old-lady presented with a history of cognitive decline, behavioural disturbance and poor co-ordination. She was assessed, investigated and cared for by the community psychiatric services.

She was born at term, following an uncomplicated delivery, reached early developmental milestones appropriately and attended a mainstream primary school. The first suggestion of cognitive problems was at the age of 8 years when a paediatric psychologist documented a verbal IQ of 65, performance IQ of 75 and general IQ of 66. At 10 years a school report noted visuospatial and motor difficulties but she was able to keep up with her contemporaries.

She went to a secondary school for pupils with mild-to-moderate special needs. She gained no formal qualifications and subsequently participated in sheltered work. She lived with her parents and attended a day centre for disabled young adults.

At the age of 29 years, her parents reported a two-year history ...

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