Rob is a 7-month-old boy who we were asked to see in the Emergency Department due to convulsive activity that happened earlier this evening. HISTORY OF PRESENTING ILLNESS: Rob was seen in the Emergency Department along with his mother and father. They expressed to us that at about just after midnight on January 13, 2016, they heard crying from Rob’s room and when they got to the room they saw that he had his head turned to the left and his extremities were shaking. They denied any symmetric activity and denied the presence of any flexion or extension. They are somewhat vague in their description, first saying that arms were locked in extension and then later saying that he was lacking tone in his arms while shaking. They were able to say that there were no vocalizations during this activity and that his eyes were open and staring forward. These convulsive episodes seemed to have lasted somewhere between 2-3 minutes. After a shaking episode, they stated that he would have an apneic period for about 10 seconds where he would not breathe but would also not make any efforts to breathe. There was no cyanosis during these periods. His parents state that these episodes of shaking and apnea alternated somewhere between 6 and 10 times, lasting a total of about 15-20 minutes. EMS had been called in the meantime and Rob’s parents state that the convulsions and apneic periods stopped before EMS got there. His parents state that after this episode, it took Rob about an hour and a half to become back to normal. They said that in the meantime he was just staring and not being very interactive and smiling. Rob’s mother says that he has been feeling sick with a cough over the last 10 days. He also had congestion. She states he did have a fev... ... middle of paper ... ...: No investigations were done prior to our seeing Rob in the Emergency Department. IMPRESSION AND PLAN: Rob is a 7-month-old previously healthy boy who came to the Emergency Department with about 15 minutes of alternating apneic and convulsive-like activity. The history was quite difficult to follow in terms of timeline and difficult to get a good understanding of what the convulsive activity looked like. At this point in time, we can not definitely say what is going on. On our differential diagnosis, we are considering metabolic causes, infectious causes, structural causes and epilepsy. We will also be sure to assess for any nonaccidental injuries. We will be admitting Rob to the Pediatric Ward for further assessment, including an EEG and blood work. We have also asked Social Work to be involved with regards to the patient's prior involvement with CAS.
Bourgeois notified of the decision to detain client for Grave Disability and was in agreement with client being placed for further psychiatric care. Dr. Bourgeois requested the name and contact information for help in facilitating client being transferred to an LPS designated facility, due to being unable to place him on multiple occasions. This writer contacted Supervisor Robin Boscarelli regarding this issue. It was decided that a member of the Treatment Team will be reaching out to the Hospital Unit Clerk, Gina later this morning. Dr. Bourgeois was in agreement with this plan. Client's Clinic to be notified via email of this Crisis
Charles has agreed to medication protocol of Haldol injections and Resperadol. He adamantly refuses psychotherapy. While hospitalized Charles makes reference to being sexually abused he refuses to go into depth or give specifics. Prior to the diagnosis Charles’s mother reports became withdrawn at the age of seven Charles’s father died in a car accident.
that caused seizures, hemiparesis, and dementia normally in the first ten years of life. The seizures that
Mr. Steinhoff reports that he has a court date next month regarding custody of his children. In preparation for this date patient reports he will be meeting with Brenda McCray and the supervisor at Haldimand-Norfolk CAS to review issues which have already been addressed and should no longer be listed as outstanding. Mr. Steinhoff acknowledges that this meeting today is a positive change in his relationship with CAS. He reports
Epilepsy, also known as “seizure disorder,” or “seizure attack,” is the fourth most common neurological disorder known to mankind, affecting an estimated 2.3 million adults and 467,711 children in the United States. Unfortunately this disorder is becoming far more common and widespread worldwide. This staggering number of cases of people suffering from Epilepsy also involves an average growth rate of 150,000 new cases each year in the United States alone. Generally, many of the people who develop who are a part of the new are mainly either young children or older adults. Your brain communicates through chemical and electrical signals that are all specialized for specific tasks. However, through the process of communication, chemical messengers, also known as neurotransmitters can suddenly fail, resulting in what is known as a seizure attack. Epilepsy occurs when a few too many brain cells become excited, or activated simultaneously, so that the brain cannot function properly and to it’s highest potential. Epilepsy is characterized when there is an abnormal imbalance in the chemical activity of the brain, leading to a disruption in the electrical activity of the brain. This disruption specifically occurs in the central nervous system (CNS), which is the part of the nervous system that contains the brain and spinal cord. This causes an interruption in communication between presynaptic neurons and postsynaptic neurons; between the axon of one neuron, the message sender and the dendrite of another neuron, the message recipient. Consequently, the effects that epileptic seizures may induce may range anywhere from mild to severe, life-threatening ramifications and complications. There are many different types of seizures associa...
Diagnosing Epilepsy can be a long process with lots of steps to follow. When first going thru the process there will need to be a confirmation of parent history. Then there will be a full neurological exam followed by blood and clinical tests, to make sure it wasn’t some other type of episode such as fainting. Apart from the neurological exam, the EEG is the best tool to diagnosing seizures and epilepsy. Then the doctor will identify the type of seizures and do a clinical evaluation to determine the cause of epilepsy. Now depending on the results they will determine the best type of treatment.
Children’s Treatment Network (CTN) regrets that your son’s Diagnostic Assessment Report was inadvertently shared with the early interventionist who was in the process of transitioning Essa’s care to another early interventionist. Unfortunately the occupational therapist, Laurie Schultz, who participated in the diagnostic feedback session failed to share your wishes to only share the report with the two physicians named. On discussing the information with Laurie it was clear that this was truly an error on her part and she sincerely regretted not informing the early interventionist not to access the report. Not sharing the report with the early intervention staff involved is not the usual process and therefore on not hearing about any restrictions,
Gibb’s model (1988) first describes the event, so my description of the event is: Mr X was admitted to the medical assessment unit (MAU) from the A+E (accident and emergency) department, with a preliminary diagnosis of a T.I.A. (transient ischemic attack) and dysphasia. Ross and Wilson (1996) describe this as, caused by small...
Not everyone who has a seizure has epilepsy. Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures. Unprovoked means that there is no immediate cause for the seizure, such as a fever, an infection of the brain, or head trauma. Nearly 10 percent of people will have a seizure during their lifetime; most of these are provoked seizures during an acute illness or condition. These people may never have epilepsy. There are two types of seizures people can have. One is partial seizure or focal they begin in one part of the brain. They cause varied symptoms auras which is a funny feeling in your stomach, staring, chewing, lip smacking, shaking, or stiffness in parts of the body. Generalized seizures are when the entire brain is effected. This causes loss consciousness. One type is grand mal is when the body stiffens and jerks. Another type is petit mal, which is momentary loss of consciousness without abnormal body movement. Some factors of this are infections of the brain this includes meningitis, encephalitis, and brain abscess. Strokes are also a risk of epilepsy. Also alcohol can cause seizures for heavy drinkers when they stop drinking abruptly (withdrawal seizures) and also have a good chance of epilepsy. Epilepsy can also cause brain tumors usually they are slow growing and don't affect them for years. Some other factors that cause epilepsy is age the risk of seizures is higher in young children. Also gender epilepsy is higher in males than in females. The most common treatment for epilepsy is the daily use of anticonvulsant or antiepilectic drugs to prevent seizures. These medications act on brain signals to limit hyperexcitability. While medications do not cure epilepsy, they allow many people to live normal, active lives. Other treatments are vagus nerve stimulation this treatment involves electronic stimulation of the brain using an implanted device like a pacemaker. Another is epilepsy surgery this is when a part of the brain that is causing the seizures is removed so that it prevents it from spreading to anther part of the brain.
Epilepsy is a condition characterized by recurrent seizures which are unprovoked by any immediately identifiable cause (Hopkins & Shorvon, 1995). It is also known as a seizure disorder. A wide range of links and risk factors are associated with the condition, but most of the time the cause is unknown. Epilepsy is one of the most common neurological disorders, affecting approximately two and half million people in the US and about 50 million worldwide. Though seizures can occur at any age, epilepsy is most commonly seen in children and the elderly. Most respond well to treatment and can control their seizures, but for some it is a chronic illness. A clinical diagnosis is the first step to finding a potential cure for the disorder.
Central Nervous System: He doesn’t have any parasthesia and no experienced of unconscious or fits. He doesn’t have any weakness of limbs and no hearing problems as well as visual disturbance.
The topic of epilepsy itself has always been important and close to me personally, due to the fact that my, currently 8 years old, brother has had issues with it his entire life. Although he does have a form of the neurological disorder and similar background, his situation is much more complicated than the exact diagnosis being JAE. Juvenile Absence Epilepsy is an epilepsy syndrome with absence seizures, or staring spells, during which the child is not aware. It can begin from later childhood years up through adolescence, usually being a life-long condition. The cause of the syndrome is predominantly genetic, rarely ever being simply acquired by a person (child).
Oxygenation: The patient’s general appearance was calm, quiet and cooperative. She didn’t exhibit any signs or symptoms of distress. Breath sounds were clear on auscultation of all the lobes, both during inspirations and expirations. The patient’s respiratory rate was 17. She didn’t exhibit any signs or symptoms of respiratory distress. Respiratory effort was minimal with small chest and abdominal movements. Heart rate was 86 beats per minute. Mucous membranes were pink and moist; capillary refill less than 3 seconds. The patient denies a medical history. Patient states that she is taking the prenatal vitamins. She denies any trauma to her belly with the fall; however, she said that her baby is not moving as frequently as she was moving before the fall. A Fetal hear assessment of the baby was obtained and the baby’s hear rate was 141 beats per minute. Patient denies any vaginal bleeding. The patient’s oxygen saturation was 99% at room
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.