Presentation A patient who wears hard, impermeable, or rigid gas-permeable contact lenses comes to the emergency department in the early morning complaining of severe eye pain after they have left their lenses in for longer than the recommended time period.…
Presentation Conjunctivitis is the most common diagnosis in patients with a red eye and discharge, but not all red eyes are the result of conjunctivitis. With bacterial conjunctivitis the patient complains of a red, irritated eye and perhaps a gritty…
Presentation An older patient, complaining of isolated “weakness” or an inability to perform the usual activities or care for oneself, comes to an acute care clinic or emergency department (ED), often brought in by family members. You’re Reading a Preview…
Presentation The patient presents with a complaint of dizziness, which may be abrupt or gradual in onset. The symptoms may be reported in many different ways, such as lightheadedness, disequilibrium, room-spinning vertigo, imbalance, wooziness, or incoordination. The patient may have…
Presentation The patient experiences a brief loss of consciousness, preceded by a feeling of lightheadedness, a sense of warmth and nausea, and the awareness of passing out. This may or may not be accompanied by weakness and diaphoresis. In addition,…
Presentation A patient presents after a fall from standing with a head strike. There was no loss of consciousness, but a small laceration is noted on the occiput with surrounding swelling, described by bystanders as a “goose egg.”The patient complains…
Presentation The patient complains of a dull, steady (nonpulsating) pain, described as a pressing, tightening, squeezing, or constricting band, located bilaterally anywhere from the eyes to the occiput, perhaps including the neck or shoulders. Often the headache is a bilateral…
Presentation Frightened parents bring in their young child who has just had a first-ever generalized seizure with jerking tonic-clonic movements and loss of consciousness (LOC), followed by a period of postictal obtundation that gradually resolves within 30 minutes. The patient…
Presentation The patient with seizure may present in full tonic-clonic seizure or may have experienced a seizure witnessed by others. Seizure may be preceded by an aura or have sudden onset without warning. Most patients presenting with seizure have a…
Presentation Migraine headache is one of the most disabling neurologic disorders, with a lifetime prevalence of 33% in women and 13% in men worldwide. In a third of cases, patients will have an aura, which can manifest with visual phenomena…