Anti-Hu meningoencephalitis most commonly affects males with small cell lung cancer (SCLC). The patient represents an atypical presentation of this condition with interesting findings on EEG. 

A 66-year-old woman with a past medical history significant for breast cancer with lumpectomy and radiation in 2015, moderate alcohol abuse, hypertension, and asthma, presented to her physician after her son noted two weeks of concerning behavioral and personality changes, including impulsive decision making and impaired memory. Family noted that the patient recently bought an expensive SUV to replace her modest sedan, called a contractor to begin remodeling her house while also listing her house for sale, and began having difficulty remembering day-to-day tasks. The patient was admitted for further work-up, and she became increasingly less responsive. She was connected to continuous EEG, which showed rhythmic delta waves with triphasic morphology intermixed with faster activity which was concerning for nonconvulsive status epilepticus. She responded well to one dose of intravenous Lorazepam; however, subsequent doses failed to improve her symptoms. She was transferred to the ICU, intubated, and placed on a Midazolam drip. A lumbar puncture ultimately showed the presence of anti-Hu antibodies. Her electrographic seizures were controlled, but she eventually passed away due to medical complications following a procedure before an accurate neurological exam could be assessed.