Case Presentation: A 38-year-old Caucasian male with no significant prior medical history presented with an acute CVA based on the presence of fatigue, blurry vision, ataxia, headache, and numbness. His MRI showed “multiple small foci of high DWI/ADC signal” in the bilateral cerebral and cerebellar hemispheres consistent with small acute infarcts. Unremarkable CTA brain/neck, ECHO, [...]

Case Presentation: A 74-year-old man with a medical history of hepatitis C cirrhosis post-treatment was evaluated after he was found to have hepatocellular carcinoma on abdominal MRI. The carcinoma occupied almost the entire right hepatic lobe with macrovascular invasion without evidence of metastatic disease. The initial alpha-fetoprotein level exceeded 2000 nanograms per milliliter. Subsequently, the [...]

Case Presentation: A 37-year-old woman with a history of HTN and ESRD due to preeclampsia now on hemodialysis presented to the hospital for two days of weakness, confusion, and fever. Notably, she had a recent history of blood cultures growing Acinetobacter for which she had received a course of antibiotics. Blood cultures taken at dialysis [...]

Case Presentation: Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by symptoms of encephalopathy and radiographic findings suggestive of vasogenic edema. Although PRES is most often triggered by hypertensive emergencies, sepsis and immunosuppressive medications have also been implicated in its pathogenesis. We present a case of PRES due to lithium toxicity.A 47-year-old female [...]

Case Presentation: A 53-year-old female with a past medical history of hypertension presented with three days of progressively worsening confusion, aphasia, poor PO intake, and urinary incontinence. Vital signs were within normal limits. Physical exam notable for orientation only to person and place, hyperreflexia, and no other focal neurologic deficits. Initial workup significant for positive [...]

Case Presentation: A 5-year-old boy with autism and developmental delay presented to the emergency department with acute inability to ambulate following progressive lethargy and weakness. He was nonverbal at baseline with new developmental regression and diffuse peripheral hypotonia, limiting activities of daily living. Neuroimaging demonstrated thalamic hyperintensities consistent with thiamine- and pyridoxine-related encephalopathy. Diet history [...]

Case Presentation: A 78-year-old female with a history of breast cancer and pancreatic cancer, with status post Whipple procedure and started with capecitabine one month prior to admission, severe malnutrition, started on a high-protein diet one month prior, presented with acute encephalopathy. Her symptoms started acutely as confusion, then progressed to somnolence. She was alert [...]

Case Presentation: Our 28-year-old female patient with a history of acute myeloid leukemia (AML) and allogeneic peripheral blood stem cell transplant presented to the Emergency Department (ED) for the evaluation of intermittent confusion and word-finding difficulty for one week. The patient’s vitals on admission were within normal limits. A physical examination was significant for diffuse [...]

Case Presentation: 5 59-year-old male with alcoholic cirrhosis, hypertension, COPD, and diabetes mellitus presented with a 3-month history of progressive confusion and altered mental status. His family reported memory decline, prompting multiple ER visits primarily focused on cirrhosis-related complications, overlooking the neurological symptoms’ etiology. Initial improvement following hepatic encephalopathy treatment was short-lived, leading to rapid [...]