Wernicke\'s encephalopathy (WE) is a rare, life-threatening condition in which thiamine deficiency causes dysfunction of the Kreb\'s cycle, accumulation of lactic acid in the brain tissues, and irreversible cognitive impairment. Prompt treatment with IV thiamine can reverse the process. The classic Wernicke\'s triad of ataxia, memory issues, and ocular abnormalities is not often present. Caine\'s criteria, which requires two of the following: dietary deficiencies, ocular abnormalities, altered cognition or mental status, and cerebellar dysfunction, is highly sensitive and specific for Wernicke\'s diagnosis, especially in patients with alcohol use disorder. Refeeding syndrome (RS) has similar risk factors to WE, including disease states that lead to malnutrition. Patients with RS develop WE due to thiamine depletion that occurs when oral nutrition is reinitiated after a period of poor oral intake. We present a patient with initially undetected WE who developed RS after the initiation of treatment with IV thiamine. RS prolonged the neurologic symptoms of WE and led to an extended hospital stay and significant physical debility. In our patient, WE preceded RS instead of occurring as a consequence of it. The case highlights that if one of these disorders is present, the other may not be far behind. When WE precedes RS, prolonged treatment with IV thiamine may be warranted until the symptoms of both disorders resolve.

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Neurocysticercosis is frequent in Madagascar. Its clinical presentations depends on the topography of the lesions. We report a case with gait and cognitive disorders. A 49-year-old man, right-handed, with progressive gait disorders (small steps with magnetization). On examination, he had gait disorders, associated with frontal syndrome with Frontal Assessment Battery (FAB) scale of 10/18, a Mini-Mental Status Examination (MMSE) scale of 24/30, a constructive apraxia and a clock test disturbance. The brain CT scan showed massive lesions of fronto-parietal and temporal neurocysticercosis, meningeal neurocysticercosis with racemose forms. Lesions had different ages associated with a communicating hydrocephalus. Gait disturbance and cognitive function were improved after an evacuating lumbar puncture and cysticidal treatments. This case illustrate the importance of neurological examination in a patient with neurocysticercosis. Neurocysticercosis could be a curable cause of dementia.

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Frontotemporal dementia is a neurocognitive disorder that affects language, behavior, or executive functioning. This disease includes a spectrum of presentations that includes multiple variants. The phenocopy syndrome of the behavioral variant of frontotemporal dementia mimics the behavioral variant of frontotemporal dementia. Patients with this condition show a decline in personality, social conduct, and cognitive ability but often display no signs of neurological imaging and exhibit slow progression. This case focuses on a now 70-year-old male who has shown signs of behavioral changes with a slowly progressive clinical course and minimal findings on positron emission tomography (PET) scan, but moderate changes seen on MRI. This report details a clinical presentation of an individual potentially with phenocopy syndrome of behavioral variant frontotemporal dementia and provides context to how symptoms can be managed to better help assist patients and their caregivers.

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Nitrous oxide (N2O) is a colorless, odorless gas used as an anesthetic and analgesic. It is also abused as a recreational drug, and such abuse is associated with neurological disorders and psychiatric complications such as myelopathy and, rarely, cognitive impairment. Its abuse has not been associated with acute cognitive decline. Here, we report a young girl who presented with acute cognitive impairment after excessive recreational inhalation of nitrous oxide and who recovered completely after vitamin B12 supplementation. We conclude that nitrous oxide abuse can cause acute cognitive impairment, and that this diagnosis should be considered if a patient initially presents with acute cognitive decline.

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Well-described clinical case reports have been a core component of the neuropsychiatry literature and have led to: a deepened understanding of brain-behavior relationships and neuropsychiatric phenomenology, new paths for research, and compelling material for physicians who are studying neurology and psychiatry. Six landmark neuropsychiatry cases were selected for being well described, paradigmatic, and illuminating of brain-behavior correlations: Phineas Gage, Louis Victor Leborgne (\"Tan\"), Auguste Deter, Solomon Shereshevsky (\"S\"), \"JP,\" and Henry Gustav Molaison (\"HM\"). Each case and its neuropsychiatric lessons are summarized from primary sources, highlighting some less appreciated aspects. Case reports continue to be a valuable resource for neuropsychiatric education. Yet only four of the 10 highest impact factor psychiatry journals accept case reports for publication.

Arachnoid cysts cause a wide spectrum of clinical symptoms. Often it is difficult to clearly establish the relation between the presence of an arachnoid cyst and problems reported by the patient, which may, although not necessarily, be due to chronically elevated intracranial pressure. In recent years, increasing attention is paid to cognitive disorders accompanying arachnoid cysts, such as memory disorders, attention disorders, or language function disorders. This article presents a case of an 11-year-old patient, treated at the University Children\'s Hospital in Cracow for an arachnoid cyst, located in the left middle cranial fossa. This analysis is focused on the description of cognitive and intellectual deficits of the child, as well as the discussion on their connection with the arachnoid cyst. Prior to the neurosurgical procedure, the boy presented significant deficits in cognitive functions, especially mnestic and attention functions and, also, a quite low level of intellectual functioning. Neuropsychological examination performed after the procedure indicated a significant improvement of cognitive functioning for all the functions, as well as a higher level of intellectual functioning. This analysis attempts to answer whether and to what extent the child still suffers from cognitive deficits from the organic lesions.