DIAG 2740 Chapter 15 Case Studies

DIAG 2740 Chapter 15 Case Studies - Chapter 15 Cases Case...

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Chapter 15 Cases Case #1 Sudden Onset of Unilateral Ataxia Minicase A 70 year-old semiretired janitor with a history of hypertension, went to work one morning and at 7:00 am he had sudden onset of nausea, vomiting, and unsteadiness. He was taken to the emergency room, where his exam was notable for slurred speech with slowed tongue movements, dysmetria on finger nose testing on the left, dysmetria on heel shin testing on the left, and left dysdiadochokinesia. Upon attempting to stand, he fell to the left, even when he kept his eyes open. The remainder of the exam was unremarkable. Localization and differential diagnosis 1. On the basis of the signs and symptoms shown in bold above, where is the lesion? 2. What is the most likely cause? Case #2 Walking Like a Drunkard Minicase A 76 year-old man with a history of cigarette smoking developed difficulty walking over the course of one month. He noticed that when he stood up he felt “woozy,” and he described his gait as feeling like he was drunk, saying, “my legs go one way and I go the other.” His family said he frequently lost his balance, with staggering and unsteadiness. He also had frequent mild headaches that occurred at any time of the day or night and seemed to be getting worse. Exam was unremarkable except for a wide based, unsteady gait, tending to fall to the left, especially with tandem walking. Of note, there was no ataxia on finger nose or heel shin testing, and rapid alternating movements were normal. There was no history of alcohol intake. Localization and differential diagnosis 1. On the basis of the signs and symptoms shown in bold above, where is the cerebellar lesion?
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Case #3 A Boy With Headaches, Nausea, Slurred Speech and Ataxia Chief Complaint A 13 year-old boy was brought to the pediatrician’s office because of 2 months of progressive left occipital headaches, nausea, slurred speech, and unsteadiness. History The patient was well until 2 months previously, when he began having headaches, which were initially attributed to sinus infection. The headaches gradually worsened, with headache mainly on the left occipital area, and sometimes accompanied by nausea and vomiting, but no visual changes. The headaches were worse at night and in the early morning hours. His teachers noticed that over the past few months he had some
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This note was uploaded on 11/23/2011 for the course DIAG 2740 taught by Professor Markamos during the Winter '11 term at Life Chiropractic College West.

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DIAG 2740 Chapter 15 Case Studies - Chapter 15 Cases Case...

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