A 17-year-old female presents via EMS from her boyfriend’s home after a report of two separate episodes of generalized tonic-clonic seizure like activity. She has no previous history of seizures. Per EMS, she was given versed on scene for seizure like activity lasting roughly 5 minutes. She was also febrile to 100.8°F. The emergency department team is unable to obtain a detailed history from the patient and unable to reach the family when the patient first presents to the ED…
Read MoreAustin Quinn, MD, and Meghan Beucher, MD
The patient is a 4 month-old ex-full term fully vaccinated otherwise healthy male who presented to the ED with one week of abnormal movements. The patient's mother stated that over the past week he had had increasingly frequent clusters of 5 or 6 episodes of flexing his hips and arms in toward his trunk, accompanied by abnormal eye movements with upward deviation and head drop. She sent videos to the PCP who felt it was from gas pain and started the patient on simethicone, without improvement in symptoms. Mother commented that they appeared to happen more often before sleep, but could happen when the patient was wide awake. He appeared to remain conscious throughout the episodes and would often cry afterwards.
Read MoreAn 11 year-old female presents with approximately 2 weeks of bilateral lower extremity pain that is localized to her knees and calves. The pain is worse with ambulation and not relieved with ibuprofen. She has difficulty ascending the stairs at school and recently started having trouble walking on flat ground. The patient also endorses neck, back, and shoulder pain that are less severe. She recalls an illness associated with vomiting and diarrhea that started approximately 1 week ago, which has still not resolved…
Read MoreA 52 year-old male presented to the emergency department with a chief complaint of right shoulder pain. In fact, the patient endorsed several years of shoulder pain, which he attributed to being right hand dominant, and the physical demands of his work as a contractor. One month prior to his presentation, the patient had also seen an orthopedic surgeon, who diagnosed him with a paralabral cyst, and subsequently drained it. After the procedure, the patient’s pain improved, but the effect was short lived…
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