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Clinical Reasoning: A 68-year-old man with a first presentation of status epilepticus NEUROLOGY Schneider, L., Probasco, J. C., Newsome, S. D. 2014; 82 (14): E116-E121

Abstract

A 64-year-old man with transfusion-dependent myelodysplastic syndrome (MDS), hypertension, chronic obstructive pulmonary disease, hypothyroidism, blindness from treated syphilitic chorioretinitis, and no prior seizure history presented in generalized status epilepticus. His daily home medication regimen included prednisone 20 mg (chronic therapy for MDS), diltiazem 120 mg, digoxin 250 µg, tiotropium 80 µg, and levothyroxine 112 µg. On admission he was febrile to 39.9 °C and in atrial fibrillation with rapid ventricular rate. Initial hematologic profile showed 11,910 leukocytes/mm(3) (12% immature forms, 46% neutrophils, 32% lymphocytes), hematocrit of 30.8%, and platelet count of 215,000/mm(3), with an otherwise normal serum chemistry.

View details for DOI 10.1212/WNL.0000000000000289

View details for Web of Science ID 000336497000002

View details for PubMedID 24711538