A 26 year old male presents to your Emergency Department with bilateral lower extremity weakness.  He states he recently had a “stomach bug” following a camping trip.  You suspect Guillain-Barre Syndrome.  Which of the following is most consistent with GBS?

A) CSF with elevated protein 

B) Hyperreflexia

C) Facial droop 

D) Sterile pyuria 

E) Vesicular rash 

Which anti-epileptic is most likely to cause hyponatremia? 

A. Carbamazepine

B. Dilantin

C. Valproic Acid 

D. Lacosamide

E. Levetiracetam

Answer is A - Carbamazepine or Tegretol

Bonus Question: What is the first line management in Trigeminal Neuralgia? 

Answer: Carbamazepine or Tegretol

Dr. Anil Reddy discusses status epilepticus in the Emergency Department. 

While the scuba diving decompression illnesses of decompression sickness and arterial gas embolism are treated the same, the pathophysiology and presentation are different.

A 15-year-old boy presents to the ED complaining that she cannot walk. She has been in her normal state of health except for an episode of nausea, vomiting and diarrhea 15 days ago.

This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis? 

A 60-year-old man with chronic alcohol abuse presents with altered mental status and ataxia. Nystagmus is noted. Vitals are normal. What is the most likely diagnosis?

Autonomic dysreflexia is a potentially dangerous and lethal syndrome that develops in spinal cord injury (SCI) patients resulting in acute, uncontrolled, life-threatening hypertension.

Encephalitis is defined as inflammation of the brain parenchyma, frequently caused by viruses.  Autoimmune processes can also cause encephalitis: here are some pearls on the often-forgotten Anti-NDMA receptor encephalitis.