** Clinical Quiz? A 65 -years- old woman had been operated upon recently for cancer caecum. Her postoperative course was smooth for the last 2 weeks until she developed a sudden onset tonic - clonic seizures for 4 minutes. She got intubated and mechanically ventilated then was admitted to the ICU. CT brain revealed no acute CNS insults and her metabolic profile was within normal. The patient remained stuporous, GCS of 9/15 with intermittent myoclonic jerks. Phenytoin level continued to be within the therapeutic level but QTc interval was prolonged and HR slowed down to 55/min, so that it was replaced with Levetiracetam. Eventually, EEG and MRI brain were performed and fortunately pointed out the diagnosis! Q1: According to the EEG and MRI findings, whats the most likely diagnosis? Q2: Whats your next step after reaching a preliminary diagnosis? Q3: What are other tests you will order to confirm your diagnosis?
Posted on: Sat, 10 Jan 2015 19:23:35 +0000
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