1. Signs and Symptoms of
Will Graham
All pictures are not mine I took it from
google. -sringmacchiato.tumblr.com

2. • Auditory Elemental hallucination (hearing
voices/noises that are not there)
• Visual hallucination (stags and Garrett Jacob
Hobbs)
• Lost of time (retrograde amnesia)
• Sleep-walking
• Nightmares
• Hemi spatial neglect (the clock)
• Delusion of persecution (Jack Crawford believes
he will kill again)

3. Elemental hallucination
• Hearing scratching
sounds on the
walls

4. Visual Hallucination

5. Lost of time

6. Sleep walking and nightmares

7. Hemispatial neglect
Actually the clock
frame should be
distorted too but if
I’m not wrong,
Hannibal drew the
clock frame.

8. Delusion of persecution
• The beginning stage.

9. • Depersonalization (feels his personality is not
his)
• Fregoli delusion? (hallucinating someone
familiar to be replaced on someone
unfamilliar)
• Tactile hallucination (hygric hallucination) -
sensation of touching water
• High fever.
• Mild seizures?

10. Depersonalization

11. Fregoli?
• He
thought
this guy
was this
guy

12. Hygric hallucination

13. Seizures?
• despite popular reactions to his acting of a seizure attack, it does not
depict a typical seizure of any kind in the textbook 
• There is up-rolling of eyeballs and the tonic part but the tonicity should
have cause him to fall off on the floor but he was still standing…………..
• Absence seizure are transient and does not have up-rolling of eyeball or
any physical signs.

14. Others
• Depression? Aggresion?
• In my opinion he does not display a typical
depressive nor aggressive episode.
• The aggression in the episode “Roti” where he
had a seizure was more of a panic attack.
• He was delirious, confused from the high fever
and also from the hallucinations which are
getting more vivid.

15. • Signs and symptoms does no coincide with
schizophrenia nor bipolar disorder.
• The high fever and hemi spatial defect shows
organic in pathology.
• Hemi-spatial defect shows defect to be of
temporal in origin. The neglect of the left side of
the hand of clock shows the lesion to be of right
sided in nature pertaining the temporal lobe. The
right deviation is due to the compensatory effect
of the healthy left brain.

16. Diagnosis
• One-sided encephalitis (inflammation of the
brain) is very rare. So my first thinking would
have been a one-sided brain tumour.
• Anti-NMDA receptor encephalitis commonly
presents to the doctors with psychotic
symptoms and are also more commonly found
in woman with underlying ovarian tumour.

17. Final Diagnosis
• Right sided anti-NMDA receptor Encephalitis