Jchief's Case: Possible Seizure

| * Able to describe any aches or pains * Can communicate very well but they still might find it hard to explain certain things * May have stutter issue * Some letters may not be pronounced correctly * Can recognise letters, numbers, some shapes and colours confidently * Able to add simple sums

Visual fields full to confrontation. Extraocular muscles intact. Pupils are slightly enlarged on the left compared to the right, which she states is old since her eye injury. They do respond directly and consensually. Normal facial symmetry, sensation, and movement. Tongue and uvula are midline. Normal shoulder shrug. Normal auditory acuity.

Example: She says wap instead of lap. She likes to listen to stories and responds with “what’s that?” and “Why”. She uses syntax. She understands the meaning of most words. Example: Her mother said “do you love mommy” and Haper replied “yes” the mother asked “how much” and Harper replied “sixty dollars”.

He also had right more than left mastoid opacifications and states that he was recently treated for otitis media. He has hypertension, hyperlipidemia, coronary disease and had been noncompliant with his medications in the past. His exam was essentially normal except for the subjective vertigo. There was no nystagmus and no diplopia on the initial exam. On 06/19/2015, he gave a different history. He states that he had a strike to the left temporal on Tuesday 06/16/2015. This did not result in any vertigo or any other neurological symptoms at that time. It was two days later that he had the vertigo at work. The patient also claimed that he had been seeing double since the previous night and the morning of the 19th. However, his neurological exam at that time, failed to reveal any actual disconjugate gaze. The patient had an MRI MRA, which revealed old white matter ischemic disease and mild intracranial atherosclerosis, but no evidence for acute stroke or posterior circulation significant stenosis. His diagnosis was labyrinthitis, possibly due to his bilateral mastoiditis. He was treated with Augmentin for 10 days. His symptoms resolved prior to discharge on meclizine. On physical therapy on discharge, he had no

Madelynn’s language Art skills are phenomenal, she is able to recognize the alphabet when doing activities (letter of the day), and she is able to recognize and count past the number 10. Madelynn would always talk about her family, mainly her mom, dad,pet dog, and her brother Logan. Madelynn loves to point out animals and what type of animal they are. She is able to make all the animals noises, and loves to tell me about her pet dog at home. Madelynn is able to speak in full sentences and carry on a full conversation she would always want to talk about her dad and would always ask a lot of questions like, “what is that?” and “how do you do this?”. She is also a very good listener and great a following instructions.

She is a nonsmoker, smoked for about a year in her teens. She drinks alcohol a few drinks a year. No drug use now or in the past. Her health history questionnaire is reviewed with her here in the office. She is married. She has two daughters. She has five grandchildren. She is on disability for psychiatric reasons

Vision with correction 20/30 in the right, hand motion in the left. Applanation pressure are 11 in the right and 15-16 in the left. Anterior segments are clear and quiet. ____ visual field shows a dense superior hemifield in the right and generalized constriction in the left.

Epilepsy is a condition in which a person has repeated seizures. Epilepsy increases a person's risk of falling, having an accident, and getting injured. It can also lead to complications. One rare, but serious complication of epilepsy is sudden unexplained death in epilepsy (SUDEP). The cause of SUDEP is not known. Most people with epilepsy lead normal lives.

A 23 year male of Indian ethnicity was referred to the neurosurgical outpatient department at the Royal Melbourne Hospital. He had a history of epilepsy for the previous 10 years, progressively more frequent and hindering his occupation as a chef. He reported approximately five seizures per week that were refractory to anti-epileptic medications. He was reported to have febrile seizures as child according by his parents. A typical epileptic episode consisted of lip smacking with jerky movement of the right upper limb followed by a period of unconsciousness and jerky movements of the entire body. Episodes lasted approximately one to two minutes at a time. He was seen and

The patient has positive facet loading bilaterally. He has no clonus. Gait is antalgic, with a straight cane.

The patient is 52-year-old female who presents with dyskinesias and dysarthrias in the setting of a migraine headache with photophobia. She has ongoing involuntary jerking and twitching movements symptoms present for the past 2 weeks. She has never had them before and they have become increasingly troublesome. She also presents with garbled speech along with the involuntary movements. Her medical history is significant for hypothyroidism, seizure disorder, hypotension, bipolar disorder, borderline personality disorder, schizoaffective disorder, schizophrenia and migraine. I concur with Dr. Lasheen and in view of this complicated history, as well as the multiplicity of comorbidities

She can recognize and write all of her letters, knows how to spell her first and last name, can recognize and write simple words such as “mom” and “dad”, can recognize numbers up through ten and can count up to about thirty.

Jason’s loss of sensation proposes that the dorsal columns tract and the spinothalamic tracts were damaged bilaterally around the C5 portion. The dorsal columns are responsible for transmitting information to the brain regarding is a sensory path of the central nervous system that transports localized sensations of fine touch, two-point discrimination, vibration, and proprioception from the joints and skin. The spinothalamic tracts generally convey information to the brain regarding pain, temperature, and coarse touch on the skin.

REASON FOR VISIT: Patient was brought in by mother and father after extended period of complaints regarding blurred vision and headaches. Physical activities result in some labored breathing. Patient is complaining of feeling generally lethargic. Tylenol has been effective in temporarily assisting with symptoms and discomfort. Initial blood pressure readings indicate higher than normal elevations. Also, complaints about "dizzy spells" and occasional feelings best described as vertigo.

The patient is an 89-year-old female who presented to the ED after a fall down one flight of stairs at home. The patient initially stated that she remembers the entire event and was able to call her daughter who sent the ambulance to bring her to the hospital, however it is recorded that she lost consciousness in the ambulance. This elderly lady lives alone. She denied any blurred vision, nausea or vomiting, but she is known to have SIADH which is managed as an outpatient basis with fluid restriction to a liter a day. The ED notes also indicate that she vomited a small amount after she presented. She was nauseous, which improved with Zofran. She also had systolic blood pressure readings that went from a systolic 100s into the 90s and