Behavioral Disorders Reflecting Organic Disease

To the Editor: The recent case of homocystinuria and “schizophrenia” presented by Freeman, Finkelstein and Mudd (N Engl J Med 292:491–496, 1975) demonstrates the common but noteworthy lack of appreciation of the behavioral changes that can occur as a result of organic disease. The diagnosis and management of the patient reported on was both excellent and correct, once she was brought to the attention of the departments of Neurology and Pediatrics. However, the management of this patient for the four previous years is in serious question. Although her measured intellectual level at the age of 11 was unreported, her development. . .