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Clinical Scenario 5: Fever and Seizure Introduction

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With scenario number five, I'm

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cheating just a little bit.

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Sometimes we will see the patient in the emergency

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department where the history is new-onset seizures.

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At The Johns Hopkins Hospital, frankly, a

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lot of this is secondary to other etiologies.

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For example, a patient who has had a traumatic

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brain injury who develops seizures, or a

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patient who has a stroke who develops seizures.

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Often, it may be a toxic etiology.

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For example, alcoholic seizures.

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Now, that might be alcohol withdrawal

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seizures, it may be alcoholism seizures, or it

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may be a seizure associated with IV drug abuse.

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All those can also fall into the

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category of change in mental status.

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However, when you have an additional history of

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fever associated with the seizures, then we start

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to worry about potential infectious etiologies.

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And so, with fever and seizures, the thing

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that's paramount in the clinician's mind, as

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well as your mind as an emergency department

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neuroradiologist, is: does this patient have

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imaging findings of meningitis or encephalitis?

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Infectious

Emergency

Brain

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