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…
Presentation The patient with Bell palsy can present with any of the following signs or symptoms: sudden onset of facial numbness; a feeling of fullness or swelling; periauricular pain; muscular facial asymmetry; an irritated, dry, or tearing eye; drooling; or…
Presentation The patient with psychogenic nonepileptic attack (PNEA), also known as psychogenic nonepileptic seizure (PNES), typically presents with the appearance of having tonic-clonic seizure activity or can develop this during a visit. There may be a history of sexual abuse,…
Presentation The patient presenting with hyperventilation syndrome typically appears anxious and exhibits shortness of breath with an inability to fill the lungs adequately. The patient also may have palpitations, dizziness, intense anxiety, fear, chest or abdominal pain, tingling or numbness…
Presentation Heat illnesses comprise a spectrum of illnesses resulting from failure of the body’s normal thermoregulatory mechanisms after exposure to excessive heat. Most heat-related illness is mild; however, severe hyperthermia associated with heat stroke, neuroleptic malignant syndrome, or serotonin syndrome…
Presentation The patient with a dystonic reaction to a neuroleptic or other agent typically presents to the emergency department (ED) or urgent care center with posturing, facial grimacing and involuntary muscle movements, and/or difficulty speaking. Pain is minimal, if at…