Demo Case
DEMO CASE: DESCRIPTION
A 58-year-old right-handed man is brought in by ambulance because of sudden onset trouble talking and slurring of his speech. He was at work but on a break and smoking on the street when his co-worker noticed that he suddenly started talking gibberish at 10am. His co-worker called 911 and told paramedics that the patient also has diabetes but does not take his medication for it.
He arrives in the ER at 10:30am.
SHx: Works in retail, + smoking history, no other substances; identifies as Caucasian
Vitals: T 37, BP 200/110, HR 90 and irregularly irregular, RR 12, O2 sat 99% RA.
General Exam: appears stated age, well-groomed, overweight
Neurologic Exam:
Mental status: Alert, spontaneously tracks around the room and attends to faces, unable to follow commands, word salad and fluently pronounces words
CN: Funduscopic: AV nicking, right homonymous hemianopsia
Reflexes: right reflexes 3+, right toe upgoing.
Sensory: withdraws in all extremities
Coordination: Reaches for objects, no obvious ataxia
Gait: normal casual gait but unable to perform tandem