Case Presentation: An 80-year-old female with a history significant for breast cancer status post mastectomy with chemo/radiation therapy and phenytoin-induced liver injury in 2013 presented with nine months of weakness, weight loss, and 2-3 month history of confusion, memory loss, and widespread tremors, suspicious for focal status epilepticus. Workup revealed hyponatremia (135 mmol/L) and elevated [...]

Case Presentation: An 83-year-old male with type 2 diabetes (hemoglobin A1C of 10.9) and recurrent herpes zoster presented with 3 days of worsening unilateral facial pain, headache, rash, and nausea. Of note, the patient had been vaccinated with the live varicella zoster virus (VZV) vaccine (Zostavax) 3 years prior. Physical exam revealed a right sided [...]

Case Presentation: A 38 yr. old female presented with personality and behavior changes for the last 4 months which were described as episodes of impulsivity and outbursts of anger. Patient endorsed frequent episodes of headache and confusion caused by strong odors such as spices and garlic. She had progressive short-term memory deficit, often asking same [...]

Case Presentation: A 33-year-old woman presented with self-inflicted stab wounds to her neck and abdomen. Though she was initially alert and following commands, she was unwilling to provide a medical history and only shared that she had been experiencing headaches for three weeks prior to presentation.Labs were unremarkable, but CT scan on admission showed right [...]

Case Presentation: 62-year-old male admitted following new onset generalized tonic clonic seizure lasting 5-6 minutes witnessed by mother. Per EMS on scene, he was agitated and required ketamine and midazolam while on route to the hospital. Upon admission, he was hemodynamically stable with physical exam only remarkable for raised maculopapular rash extending from the left [...]

Case Presentation: Autoimmune encephalitides comprise a rapidly evolving group of immune-mediated disorders characterized by inflammation of the brain parenchyma. Patients with this disorder manifest a wide spectrum of neurological and psychiatric presentations developing over days to months. One sub-type is anti-NMDAR-encephalitis, which is characterized by complex neuropsychiatric features and the presence of IgG antibodies against [...]

Case Presentation: Case Presentation:A 36 year-old male with a history of HIV adequately controlled with Biktarvy and recent monkeypox infection presented with acute onset of rapidly ascending lower extremity paralysis. He presented to the ED for primary concern of severe left upper quadrant and back pain. He also noted bilateral lower extremity numbness below the [...]

Case Presentation: A 32-year-old female was admitted after a seizure. Brain MRI was unremarkable and lumbar puncture yielded 133 white blood cells with 100% lymphocytes. Within a few days, refractory seizures occurred. Due to suspected autoimmune encephalitis, plasma exchange and high-dose steroids were started. Cerebral spinal fluid (CSF) studies returned with IgG antibody levels for [...]

Case Presentation: A 71 years old female with a history of hypertension presented with nausea, vomiting, and fall. She had non-bloody, non-bilious emesis after eating pork 2 days prior to admission. She worked in a kindergarten with no definitive sick contacts. She did not have abdominal pain or diarrhea but she experienced lightheadedness. She was [...]

Case Presentation: A 25-day old, full term male, presented to the ED with one day of decreased oral intake and a rectal temperature of 39.2ºC.In the ED, the patient was febrile to 38.6 ºC and had mottled skin with an otherwise unremarkable physical examination. Initial workup included CBC with a WBC of 3.6 10^3/uL, ANC [...]