case study

Below you will find 2 case studies, each followed by a series of questions. Chose ONE question from the case study that interests you most and answer that question in approximately 150 words. Please note the case and question number in your reply. Do not answer the same question as another student unless you have a significantly different answer. If you do not like these cases and/or questions, feel free to, instead, create your own clinical scenario for a neurological disorder and see if we figure it out.

Neurology Case Study 1

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Ms. J, a 19-year-old college student, has been living in a dormitory on campus. She began experiencing severe headaches, neck pain, and nuchal rigidity, along with irritability and nausea. She noticed that when lying with her hips flexed, she found it very hard to stretch out her legs. Within a day her condition deteriorated, she experienced a tonic-clonic seizure, and she was quickly admitted to the hospital. Tests revealed increased intracranial pressure, fever, and leukocytosis. Bacterial meningitis was suspected, and a lumbar puncture was scheduled. (case adapted from Hubert: Gould’s Pathophysiology for the Health Professions, 6th Edition)

1. What signs and symptoms are indicative of bacterial meningitis? Which did Ms. J have?

2. What vital signs would be consistent with the finding of increased intracranial pressure? Why do these changes in vital signs occur?

3. Discuss the causes of meningitis. Her bacterial meningitis was most likely cause by which microorganism?

5. Discuss the transmission of bacterial meningitis. What were Ms. J’s risk factors?

6. What is a seizure and why did she have one?

7. What are the other short and long term complications of bacterial meningitis?

8. Is there anything Ms. J’s contacts should do preventatively? If so, who should do what?

9. Discuss the treatments available.

10. Discuss the vaccine(s) available to prevent bacterial meningitis. (Name, effectiveness, mode of action)

Neurology Case Study 2

A 4 year old boy is brought to his pediatrician for evaluation of a gait abnormality. His mother reports that the pregnancy and full-term delivery were without complication. His parents note that he walked later than his siblings at 19 months, and that when he did start walking, he walked on his tiptoes and waddled. There are no delays is his social, emotional or language development. His parents are now concerned because he falls frequently and has difficulty getting up. On physical examination, he has large calves. He is weak in the deltoids, biceps, and hip girdle muscles, but has relatively strong distal muscles. Family history is non-contributory. He has 2 older healthy sisters.

1. The doctor suspects Duchenne’s Muscular Dystrophy (DMD). How might the diagnosis be supported and confirmed?

2. What happens to skeletal muscles in DMD? Predict the clinical course.

3. Discuss one medication currently available to treat DMD. ( Be sure to explain how it works)

4. Discuss another medication currently available to treat DMD. ( Be sure to explain how it works and do not discuss the same medication as a classmate)

5. Discuss the types of therapy and assistive devices that will be used to prolong his mobility.

6. What other body systems are of concern in DMD? Why?

7. The mother is currently 7 months pregnant with a baby girl and wants to know if she should be concerned about this baby developing the same disorder. What do you tell her and why?

8. What research is being conducted currently in terms of advancing our knowledge in the pathophysiology or treatment of DMD?

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