Case 2: Visuo-Spatial Impairment and Psychosis due to Encephalitis

This 19-year-old man presented with an acute onset of delusions and hallucinations.  Despite his psychotic symptoms, he was able to cooperate with testing.  The Cognistat profile showed a marked constructional disability with additional problems in calculations and similarities.  This testing preceded documentation of right hemispheric slowing on the EEG. Three days later the patient became febrile and developed seizures.  Spinal fluid examination revealed a marked lymphocytic pleocytosis.  Cultures were negative, and the patient was diagnosed as having viral encephalitis.  Cognistat provided the earliest data suggestive of a neurologic etiology for his psychotic symptoms.

A score of 11 out of 12 falls within the average range.
A score of 6 out of 8 is a low average score that raises the question of an acquired impairment of attention. Problems with attention can be caused by one or more of the factors listed on page one of the Cognistat test booklet. Care should be taken in interpreting low scores in other ability areas when attention is impaired.
These Language scores fall within the average range.
A score of 0 out of 6 indicates severe spatial-construction disability that needs to be further evaluated both medically and cognitively. Although spatial-construction ability varies widely in the normal population, this score indicates moderate to severe spatial-construction disability.
A score of 12 out of 12 falls within the average range.
This patient has specific areas of impairment: Constructions, Calculations and Similarities.