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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