Explain the workup and the treatable-cause principle to the parents of a regressing adolescent — OSCE

Candidate brief

You are the paediatric registrar managing this adolescent on the ward. The task is to explain, in plain language, that the daughter's rapid change is a neurological problem called autoimmune encephalitis - a condition in which the immune system mistakenly attacks the brain - and that it is treatable when treatment is started early. You must convey honestly that a mental health presentation is one possibility but that the pattern of psychiatric change, seizures, and a movement disorder points to an inflammation of the brain that needs urgent investigation and treatment now, outline the workup and why a lumbar puncture and a scan are needed, and address the parents' fear and the relative's comment without dismissing them. Agree a clear next-step plan with a named contact and a follow-up. The consultation is ten minutes. ^{[1] [2]}