Issue: 2019 > January > case report

Bizarre behavior and decreased level of consciousness in an adult patient

J. van Son, R.C. Rietbroek, F.M. Vaz, C.E.M. Hollak
AbstractFull textPDF


This case report presents an adult patient with decreased levels of consciousness and bizarre behavior. A silent delirium was first suspected however, symptoms did not improve and further examination revealed elevated ammonia levels. A hepatic cause and portosystemic shunting were excluded and eventually a diagnosis of ornithine transcarbamylase deficiency was made. After treatment with high carbohydrate intake, a low protein diet and supplementation with arginine and sodium benzoate, the patient recovered.