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Patient Diagnosis
WILL “THE THRILL” BOULTINGHOUSE
&
SAMANTHA “THE BOSS” HALL
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:
https://www.youtube.com/watch?v=5Tqms_ZBVYk
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
https://www.youtube.com/watch?v=yEySbwbTQFk
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
 https://www.urmc.rochester.edu/highland/departm
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ents-centers/neurology/conditions-wetreat/seizures-epilepsy.aspx
http://www.webmd.com/epilepsy/
http://www.epilepsy.com/
https://en.wikipedia.org/wiki/Neurology
https://en.wikipedia.org/wiki/Epileptologist