ABSTRACT
Acute focal neurological deficits demand immediate evaluation. In this report, we present the case of a woman 20-some years of age with a history of hemolytic anemia and thrombocytopenia who presented with altered mental status and focal neurological deficits including aphasia, acute left gaze preference, right homonymous hemianopsia, right lower facial weakness, and right arm and leg weakness. Extensive neurological and hematological workup revealed that the patient suffered from focal status epilepticus associated with an extreme delta brush patten on electroencephalogram, likely secondary to thrombotic thrombocytopenic purpura. This case underscores the connection between hematological disorders and the neurological axis, emphasizing the critical role of integrating the neurological examination and neuroimaging findings to formulate an effective management plan.
ABSTRACT
Optimizing your care requires that you distinguish between provoked and unprovoked seizures and focus on key elements of the patient's history.
Subject(s)
Epilepsy , Seizures , Humans , Seizures/diagnosis , Seizures/therapy , Epilepsy/diagnosis , Epilepsy/therapy , Patient CareABSTRACT
OBJECTIVE: To appraise the current training of Neurology (N), Pediatric (P), and Med-Peds (MP) residents at MedStar Georgetown University Hospital (MGUH) in providing care to patients with epilepsy who are transitioning from pediatric to adult care. METHODS: Through an online questionnaire, we surveyed Neurology, Pediatric, and Med-Peds residents to assess their knowledge, confidence, and experience at transitioning youth with epilepsy to adult-oriented health care. RESULTS: N, P, and MP residents generally rated their knowledge and confidence at providing transition care to youth with epilepsy to be poor; however, P and MP residents rated higher in limited measures of knowledge and experience. CONCLUSION: Our appraisal of resident training in transitions care for youth with epilepsy has highlighted training elements in our institution that require attention for both adult and pediatric providers, leading to the formulation of an educational intervention that will promote experiential and multimodal approaches in this area.
Subject(s)
Clinical Competence/statistics & numerical data , Epilepsy/therapy , Internship and Residency/methods , Neurology/education , Pediatrics/education , Transition to Adult Care , Adolescent , Adult , Attitude of Health Personnel , Education, Medical, Graduate/methods , Health Care Surveys/methods , Health Care Surveys/statistics & numerical data , Humans , Young AdultABSTRACT
A 50-year old male suffered new-onset clinical and subclinical seizures provoked by acute bilateral embolic strokes in the parietal and occipital regions as a complication of aortic valve replacement surgery. After successful treatment of these refractory symptomatic seizures with intravenous propofol and antiseizure medications, video-EEG recordings revealed acute and transient fixation-off sensitivity or scotosensitivity that resolved within 10 weeks.
