WILL “THE THRILL” BOULTINGHOUSE & SAMANTHA “THE BOSS” HALL PatientDiagnosis

Raymond’s Problem Patient #3, Raymond, has been going through a rough time lately. His mom has brought him in and has said what has been going on with poor ole Raymond. He has been very aggressive and angry lately. However, his mother believes this could be an effect of her and his father getting a divorce. Last night, Raymond attended a laser tag birthday party at a friend’s house. After a night of partying hard and little sleep, Raymond started shaking and convulsing. He quit this episode before his mom arrived, but she still wanted to get him checked out. Raymond doesn’t remember falling to the floor and he smelled a very unpleasant odor right before he went down.

Differential and Accurate Diagnosis Raymond’s symptoms show that he could have brain damage to the frontal lobe because he is behavioral issues and had a sudden episode of convulsions. Raymond’s symptoms also show that he could have a stress related seizure. However, using all the data that his mother provided, we conclude that he has epilepsy. Seizures can occur due to stress, light flashing, and sleep deprivation. Raymond experienced all these things the night before or during his epileptic seizure. Raymond experienced an atonic myoclonic seizure. He suddenly fell to the ground and started shaking and convulsing; those are key characteristics for both types of seizures. Raymond also had an aura, a sensory phenomena that occurs before a seizure. His aura was that he smelled a horrible smell. This shows that he had a seizure and a characteristic of having epilepsy is having an aura. Clearly, he has an aura. This also supports the diagnosis of epilepsy. Epilepsy seems to be the only logical diagnosis for Raymond. Using all the data given that is what we diagnosed and what we are sticking with.

Tests To be more accurate, even though we are confident in our diagnosis, Raymond should go through the following tests: EEG, which shows electrical signals from the brain, blood test, which you do by drawing blood, PET scan, which is used to locate the area of the brain that causes the seizures, and a spinal tap, which analyzes the fluid surrounding the spinal cord. Below is a video explaining the signs and symptoms of an epileptic seizure:

Prognosis Patients whose epilepsy is well controlled have a normal lifespan. They also have normal lives just like any one of us in this room. However, many go through therapy. People with severe seizures that resist treatment have, usually, a shorter life expectancy and an increased risk of cognitive impairment, particularly if the seizures developed in early childhood. Epilepsy may cause behavioral issues and emotional problems within the patient. Patients with epilepsy have an increased risk of poor self-esteem, depression, and more likely to commit suicide. These reactions may be caused by the uncompassionate behavior received by people who don’t understand what people like Raymond have to endure. Epilepsy impairs the ability to drive due to the fact that they may have a seizure while driving. Epilepsy physically can cause problems.

Errors in Communication

Neurologist Someone with epilepsy should visit a neurologist. Neurologist will identify what area of the brain is triggering the seizures and will prescribe the patient with medication and prescription. The neurologist will also perform certain tests to see where the seizures are occurring in the brain and to see what may be causing the seizures.

Epileptologist An epileptologist is a neurologist that specializes in epilepsy. This career is mainly for the individuals with epilepsy that have severe, debilitating seizure that are difficult to control. An epileptologist usually becomes involved in order to help these horrible, advanced seizures at bay.

Physician’s Assistant A Physician is someone that your neurologist communicates with to find out how treatment is going and what symptoms you are still having. They take your medical history and recorded symptoms to the neurologist to help find if you need a change in treatment or medications.

Treatment Treatments for epilepsy vary. They include the ketogenic diet, which is a diet that consists of high fat intake and low carb intake, vagus nerve stimulation, which is a when a pacemaker-like device that generates pules of electricity to stimulate the vagus nerve, temporal lobe resection, which cuts away temporal lobe tissue to control seizures, and medications, which hold the seizures at bay. They are many forms to hold back this terrible disability.

Sources ents-centers/neurology/conditions-we- treat/seizures-epilepsy.aspx ents-centers/neurology/conditions-we- treat/seizures-epilepsy.aspx