Case Presentation: A 24-year-old black male with a history of generalized epilepsy first diagnosed one year ago presented to the Emergency Department (ED) after one episode of a witnessed generalized tonic-clonic seizure. Upon arrival at the ED, he was at his baseline mental state. However, just moments later, he had another refractory generalized tonic-clonic seizure [...]

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: Case 1: A 14-year-old male presented to the ED with history of a convulsive syncopal episode (third lifetime event). All syncopal episodes occurred with exertion and required cardiopulmonary resuscitation. Episodes were initially considered to be due to a seizure disorder and were treated with antiepileptic therapy (Keppra). Given event recurrence despite escalating doses [...]

Case Presentation: A 19-year-old male with past medical history of well-controlled juvenile myoclonic epilepsy was transferred from a community hospital for management of acute necrotizing pancreatitis. Upon arrival, he was severely hypovolemic and hypotensive, prompting aggressive intravenous fluid resuscitation and initiation of vasopressor therapy. He became obtunded, and was intubated for airway protection. Broad-spectrum antibiotics [...]

Case Presentation: A 60 year-old female with no significant past medical history was brought in as a level 2 trauma after being involved in a motor vehicle accident. The non-contrast head CT demonstrated bilateral frontal brain lesions, prompting a brain MRI which revealed a non-enhancing T2/FLAIR hyperintense lesion in the anterior frontal lobes and crossing [...]

Case Presentation: A 13-year-old female with Aicardi syndrome and treatment-resistant epilepsy presented to the emergency department with several weeks of diarrhea and vomiting. Her review of symptoms was negative for recent fevers, chills, shortness of breath, cough, sick contacts, or respiratory distress. Physical exam was notable for intermittent discomfort with palpation in the right upper [...]

Case Presentation: A 66-year-old male with hypertension, type 2 diabetes, hyperlipidemia, pulmonary emboli with +lupus anticoagulant, and intrathecal morphine pump presented for increasingly frequent episodic altered sensorium. Episodes were described as < 30 seconds of paresthesia, speech arrest, and déjà vu; no loss of consciousness or focal deficits. Onset was 2-3 months prior with associated [...]

Case Presentation: A 32-year-old female with focal epilepsy presented with several episodes of drop attacks with associated loss of consciousness (LOC). There were no witnessed tonic-clonic movements or prolonged post-event confusion. There were no prodromal symptoms including chest pain, palpitations, or features of increased parasympathetic tone. Vital signs and physical exam were normal. Initial electrocardiogram [...]

Case Presentation: A 27 year old woman with systemic lupus erythematosus (SLE) and history of a single seizure episode presented with acute altered mental status. The patient was initially disoriented and nonverbal, able to open eyes but unable to track, intermittently responding to commands, and later deteriorating, becoming obtunded and eventually comatose. Her NIH Stroke [...]

Case Presentation: A 44-year-old female with history of a seizure disorder presented with status epilepticus. She had four witnessed seizures with generalized convulsions at home and two more en route to the hospital with EMS, for which she received two doses of 5mg of midazolam. Upon arriving to the ED, she had two to three [...]