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Emergency room when the paramedics (Click here)
You are the senior resident in the emergency room when the paramedics bring in a patient having
generalized seizures. Paramedics found him 25 minutes ago in his apartment having convulsions. The
seizures ceased after he was given 2 mg of lorazepam in the field, but recurred about 15 minutes later.
There are few details about his past medical history. The landlord said the patient had been acting
strangely over the previous 2-3 days, but doubted the patient had ever had seizures before. You walk
into the treatment room and see a young man who is unresponsive and having rhythmic, synchronous
jerking movements of all 4 limbs.
1) Summarize the case briefly, including neuroanatomic localization and pathogenesis.
2) What is the diagnosis? Name 3 conditions associated with this diagnosis, and explain which seem
more or less likely based on the available information.
3) What additional information (history, exam, laboratory or other studies) would you like to obtain?
4) Assuming your most likely diagnosis is correct, how would you manage this patient? How would you
monitor his condition and its treatment? What is the prognosis?(Click here)
Case 43
You are the senior resident in the emergency room when the paramedics bring in a patient having
generalized seizures. Paramedics found him 25 minutes ago in his apartment having convulsions. The
seizures ceased after he was given 2 mg of lorazepam in the field, but recurred about 15 minutes later.
There are few details about his past medical history. The landlord said the patient had been acting
strangely over the previous 2-3 days, but doubted the patient had ever had seizures before. You walk
into the treatment room and see a young man who is unresponsive and having rhythmic, synchronous
jerking movements of all 4 limbs.
1) Summarize the case briefly, including neuroanatomic localization and pathogenesis.
2) What is the diagnosis? Name 3 conditions associated with this diagnosis, and explain which seem
more or less likely based on the available information.
3) What additional information (history, exam, laboratory or other studies) would you like to obtain?
4) Assuming your most likely diagnosis is correct, how would you manage this patient? How would you
monitor his condition and its treatment? What is the prognosis?