University educated man with childish behavior

Abstract

A 39-year-old man, a human resource executive, was seen at the outpatient clinic of the Behavioral and Cognitive Neurology Unit of the Hospital das Clínicas, a public university hospital in São Paulo, Brazil. His wife reported that about 4 years before, she noticed that he was manifesting mild behavioral and personality changes characterized by irritability, a tendency for social withdrawal, together with a more rancorous and even mean personality trait. Progressively, he gave up drinking alcohol, which he used to consume in moderate amounts, and libido became extremely reduced. Then he started to complain of difficulties in his professional activities and to manifest obsessive-compulsive behaviors such as to demand for perfectly ironed clothes or to soap his body several times during bathing. He had an acute and rapidly reversible episode of paralysis of his legs and right arm. After a few months, he had another similar episode involving only the right side of the body, including face. He was seen by physicians and after several tests the diagnosis of probable viral meningitis was undertaken. Test for HIV-1 infection was reported to be negative. He was dismissed from his job because he could not handle it any more. Ginkgo biloba and HydergineR were prescribed. His behavior deteriorated to a more childish one with frequent cries when his demands were not immediately fulfilled. Although he had had the old habit of speaking aloud about his problems, this trait became very much increased and associated with intense gesticulations. More recently, his wife also noticed a decrease of his memory. The patient complained of lack of concentration and difficulties in organizing his activities. General history University educated man with no other medical problem. © Cambridge University Press 2011.