Worsening Weakness: An Interesting Case of GBS

An 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…

Neurology, PediatricsNichole MichaeliJune 12, 2020pediatrics, GBS, Guillain-Barre syndrome, neurologyComment

The High Coast of Smoking: An Interesting Case of Pancoast Syndrome

A 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…

Neurology, OrthopedicsGuest UserMarch 13, 2020pancoast, tumor, shoulder, horner's syndrome, horner syndrome, neurology, CPCComment

Idiopathic Intracranial Hypertension

A 22 year-old female with a medical history of migraines and obesity who presents to the Emergency Department with a headache. Her headache was gradual in onset, but has progressively worsened and has not been relieved with NSAIDs. She describes the headache as dull and pounding with photophobia and phonophobia. She also notes associated nausea but no vomiting, and no associated neurologic complaints. She does note that she thinks during a previous ED visit at an outside hospital she was told she may have “high pressure in her head” but she does not remember the details and is not on any medication for it…

Ultrasound, Neurology, OpthalmologyMichelle MylesOctober 18, 2019Ultrasound, #POCUS, #FOAMedComment

Extra Dry or Up With a Twist? A Take on The ‘Migraine Cocktail’

You’re seeing a patient in the community emergency department with a primary headache disorder. Based on your history & physical examination skills, you have considered and ruled out all dangerous secondary headache causes such as intracranial hemorrhage, sentinel bleed, meningoencephalitis, abscess, tumor, temporal arteritis, hypertensive encephalopathy, acute angle closure glaucoma, etc. With many classes of treatments available, providers have typically used some form of a ‘migraine cocktail’ including IV prochlorperazine, IV ketorolac, IV diphenhydramine, IV dexamethasone, and/or IV normal saline…

Community EM, NeurologyCameron Gettel August 9, 2019Community EM, Migraine Cocktail, #FOAMem, MigraineComment

The Obtunded Patient

Neurology, Toxicology, Critical Care, Community EMSarah Joseph August 20, 2017baclofen overdose Comment

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