Case Presentation: A 74-year-old Caucasian male presented to our emergency department with unintentional movements of right arm and right leg for 1 day. He was diagnosed with type 2 diabetes mellitus 20 years ago and is not compliant with his insulin regimen. His medical history is also significant for diabetic neuropathy, hypertension and depression. Physical [...]

Case Presentation: A previously healthy 13-year-old male presented with a chief complaint of lower back pain and rash for the past 3 weeks. Associated symptoms included profuse sweating and 10/10 lower back pain radiating to his legs that had progressed in severity with inability to ambulate. On additional questioning, other symptoms included nausea, vomiting, diffuse [...]

Case Presentation: A 70-year-old male with a past medical history of hypertension presents to the hospital for new onset of right-sided chorea interfering with his everyday activities with no associated weakness, numbness, speech, visual disturbances, rashes, or joint pains. A full initial laboratory work-up was performed notable for non-hemolytic anemia and elevated inflammatory markers. CT [...]

Case Presentation: A 62-year-old man with history of end-stage renal disease and poorly controlled type 2 diabetes mellitus presents to the hospital after a fall due to unsteady gait and was noted to have facial movements similar to tardive dyskinesia, whole body chorea, and hyperkinesis of torso and bilateral extremities. On admission, he had an [...]

Case Presentation: 52-year-old female with history of Stage IIIA triple negative right sided breast cancer, seizure disorder, and s/p lumpectomy presents with ataxia, confusion, and dyskinesia over the past 2 weeks. The patient is chronically on phenytoin, ondansetron, paroxetine, and potassium supplements. She has been on phenytoin since her last seizure three years ago. She [...]

Case Presentation: A 54-year-old man with congestive heart failure, chronic kidney disease and atrial fibrillation (on digoxin 0.125 mg daily for 3 years) presented to the emergency department with fatigue, weakness, vomiting, poor oral intake and whole body “involuntary sudden movements.” Neurological exam revealed generalized symmetrical choreiform movements more pronounced in the head, upper torso [...]

Case Presentation: A 79-year-old male with type 2 diabetes mellitus presented after being found down by a neighbor. Patient reported generalized fatigue. On exam, he was not alert or oriented, but otherwise had a non-focal neurological exam. Glucose was 742 mg/dL, bicarb 15 mmol/L, anion gap 22.8 mmol/L, and beta-hydroxybutyrate 3.92 mmol/L. CT head was [...]

Case Presentation: A 76 y.o. female with history of chronic diastolic heart failure and poorly controlled polycythemia vera (PV) on 500 mg of hydroxyurea daily presented with 2 days of progressive difficulty breathing, sialorrhea and uncontrolled movements of the face and mouth. Due to general malaise, she stopped taking her furosemide and hydroxyurea 2 days [...]

Case Presentation: A 79 year-old female with a history of congestive heart failure (CHF) and poorly controlled type two diabetes mellitus (T2DM) presented from sub-acute rehab (SAR) with shortness of breath and bilateral lower extremity edema. In the ED, her vitals were stable except for mild hypoxia requiring 2L of oxygen. Labs revealed elevated B-type [...]