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Causes of a 15-Point IQ Drop: Neurological, Medical, and Environmental Factors
A 15-point decline (one standard deviation) in measured IQ is clinically significant and warrants thorough investigation.
Potential Etiologies
- Acquired brain injury: Traumatic (TBI), stroke, aneurysm, anoxia.
- Neurodegenerative disease: Dementia (Alzheimer's, frontotemporal), Huntington's, Parkinson's plus syndromes.
- Neuropsychiatric disorders: Schizophrenia (cognitive decline), severe depression (pseudodementia).
- Toxic/metabolic: Lead/mercury poisoning, carbon monoxide, chronic alcohol, hepatic/renal encephalopathy.
- Infectious: HIV encephalopathy, neurosyphilis, prion disease.
- Nutritional: B12/folate deficiency, severe protein-calorie malnutrition.
- Epilepsy: Uncontrolled seizures, medication side effects.
- Psychosocial: Chronic severe stress, sensory deprivation (rare).
Evaluation
Neurological exam, neuroimaging (MRI), laboratory studies (metabolic, toxicology, infectious), formal neuropsychological testing. Early diagnosis enables targeted intervention.
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