Case Presentation: A 57-year-old woman with history of bipolar I disorder treated with risperidone and lithium for over 10 years was sent to the ED for stroke evaluation by her primary care physician due to significant confusion and slurred speech. The patient’s family reported a 3-day history of tremulousness, a week of ataxia with a [...]

Case Presentation: A 67 year-old woman presented with six weeks of worsening disorientation. Her husband reported severe insomnia, abnormal behaviors, decreased short-term memory, and very labile mood. She had a history of well-controlled bipolar disorder on chronic lithium therapy. She had a forty pack-year smoking history. She was diagnosed with a urinary tract infection and [...]

Case Presentation: A 47-year-old woman with migraines, bipolar disorder, and hypothyroidism presented with a 2-day headache that was not improving with sumatriptan. She also complained of generalized weakness, dizziness, nausea, and vomiting. Workup revealed diabetic ketoacidosis, with blood glucose 530 mg/dL, venous pH 7.02, bicarbonate of 8 mmol/L, and anion gap 29. The patient had [...]

Case Presentation: A 75 year old male with atrial fibrillation, osteomyelitis of the right first digit of the lower extremity on IV Vancomycin presented as a transfer from an outside hospital with 3 weeks of worsening pressured speech, delusions, insomnia, and a seizure like event. The patient was admitted for further work up and management [...]