Case Study 3: Rambling, Incoherent Speech
Case study 3: Connor—Rambling, incoherent speech Tap the image to view the case. A 22-year-old college student is brought in confused with rambling, incoherent speech. His frat brother tells you that it is pledge week, and new frat brothers were asked to stand on one foot, drink a 6 pack of beer in 10 minutes, […]
Case Study 2: Hip Fracture after a Seizure
Case study 2: Louise—Hip fracture after a seizure Tap the arrow to view the case.A 79-year-old woman is admitted for a hip fracture after a seizure/fall. She has a known complex seizure history (this was her only seizure in 5 years) and a history of TIA and osteoporosis. On admission yesterday at 5 pm, she […]
Case Study 1: Confused and Barely Responsive
Case study 1: Sharon—Confused and barely responsive Tap the image to view the case. A 72-year-old woman who lives independently is brought in by her neighbor after being found confused and barely responsive. Review of her chart shows that she has hypertension, osteoporosis, GERD, and T2DM. Her last visit, 3 weeks ago, shows that she […]
Virtual Neurology Clinical Case Studies: MEDCLIN530
This course guide contains information for the Online Neurology Clinical Cases course. This is an exciting opportunity that will provide an opportunity for you to develop your knowledge and skills related to neurology. Virtually every type of clinician needs to know some neurology to care for patients. The online course will review key concepts and […]
11. Altered Mental Status
Author Dawn DeWitt, MD In this module A case-based approach to altered mental status Cognitive impairment in altered mental status Delirium: Acute onset, confusion, often fluctuating. Dementia: Sub-acute or gradual onset. Family member concerns often the initial presentation. Coma: Unresponsive. General evaluation Hx for depression, sleep, alcohol/drug use, FH, seizure. Medication review including OTC use. […]
References
Kumar A, Maini K, Arya K, et al. Simple Partial Seizure. [Updated 2020 Nov 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Types of Seizures: Epilepsy. Centers for Disease Control and Prevention. Wirrell, E. ILAE classification of seizures and epilepsy. In: UpToDate. Updated Aug. 17, 2021. Korff, C.M. Childhood absence epilepsy. In:UpToDate. […]
Knowledge Check: Matching
While this knowledge check is “open book,” the best way to learn is to practice spaced-repetition “free recall,” so try to answer these without looking. Tap two cards to make a pair To redo or start over on these matching activities: Click on the hamburger icon in the upper right-hand corner. Click the trash icon.
Case Study 4: New Onset Aphasia
Case study 4: Ernie—New onset aphasia Tap the arrow to view the case.A 78-year-old male with a history of metastatic lung cancer, migraines, DVT, DM, HTN, and hyperlipidemia presented to the ED yesterday with new onset aphasia. His wife reports that, at dinner time last night, he was confused, not making sense, smacking his lips, […]
Case Study 3: Confused
Case study 3: Ashley—Confused Tap the image to view the case. A 24-year-old woman is brought to the ED confused. She is incoherent when she speaks. Per EMS report, she had a generalized tonic-clonic seizure 15 minutes ago. Witnesses saw her pull her car to the side of the road and began to shake inside […]
Focal Seizures
Abnormal electrical activity, at least initially, in one hemisphere of the brain (subcortical structures or neocortex); localizes to specific area on EEG or clinical findings. Often spreads bilaterally to become generalized. Subtypes Motor onset: Automatisms, tonic, atonic, clonic, myoclonic, epileptic spasms, hyperkinetic Non-motor onset: Autonomic, emotional, sensory, cognitive, behavior arrest clinical presentation Many different signs […]