Neurological Disease Case Study

From the information above what do you think could be causing Mrs. Moreno’s headaches mood swings and her motor deficits?

Age related decline, maybe a brain tumor because of quick onset, brain inflammation

What tests do you think the doctors should perform to gather more information about the patient?

MRI and CT tests

Based on the general description of symptoms, what specific symptoms of Huntington’s disease does Dr. Morelli suspect in Mrs. Moreno?

Uncontrolled movements and unsteadiness. Mood swings. Hyperkinetic disorder → lots of movement (unwanted movements)

Based on the general description of symptoms what specific symptoms of Parkinson’s disease does Dr. Perez suspect in Mrs. Moreno?

Stiffness of limbs and upper extremities. Mood swings. Hypokinetic → no movement

How can the symptoms indicate that it could be both Parkinson’s or Huntington’s disease?

Early symptoms are very similar to each other.

What types of tests are needed to properly diagnose Parkinson’s disease or Huntington’s disease?

MRI or CT scans. PET scan for dopamine. Run a genetic test to see how many times CAG repeats.

Why could swimming in the lakes (exposure to lake water) provide insight on the underlying disease?

A lot of bacteria in fresh water lake. Primary amebic meningoencephalitis.

Which symptoms or observations are consistent with multiple sclerosis or Guillain-Barre syndrome? Which are not?

Multiple Sclerosis: Vision issues, motor difficulties, Testing- MRI and spinal tap. Guillain-Barre: Weakness in upper body (motor issues), double vision, unbalanced movement, jerky gate Testing- spinal tap, electromyography, nerve conduction studies.

List the symptoms that are associated with Creutzfeldt-Jakob disease that Carmen is presenting.

Symptoms: Personality changes, jerky movements, blurry vision. Testing: EEG, MRI, spinal tap. This disease is prion disorder and prions are very dangerous as they like to stick around.

What abnormalities are the doctors looking for in the blood tests for a Huntington’s diagnosis? What abnormalities are they looking for in the CT scan? How do these abnormalities manifest physically in the affected patient?

Looking for abnormal number of CAG repeats

What is your diagnosis at this stage of the case study? Why?

To early to tell but possibly Creutzfeldt-Jakob disease.

Why do you think Dr. Gorga suggested the idea that Mrs. Moreno might have measles?

Subacute sclerosing panencephalitis is she had measles recently.

With respect to the testing for MS, what results would indicate the MS diagnosis?

Looking for changes in white matter looking at scars on MRI. Look for scars or lesions on MRI.

What is and what are all of the symptoms associated with subacute sclerosing panencephalitis? Guillain-Barre?

Subacute sclerosing panencephalitis (SSPE) - personality changes, jerking movements. Testing MRI. Guillain-Barre - demyelination

How rare is a case of subacute sclerosing panencephalitis? Guillain-Barre?

SSPE is rare in the US. Guillain - Barre is rare but more common than SSPE.

What is your diagnosis at this stage of the case study: SSPE or Guillain-Barre? Why?

SSPE because demyelination is not occurring. No cure for SSPE