Neurological Disorders Paper
The possibilities that Mrs. Smith current mental status was changing is very high because of her age and the presence of comorbid disease that is so stressful for the elderly. According to her daughter’s report, she says that Mrs. Smith was unable to remember the names of her grandchildren. Besides, Mrs. Smith had disturbed sleeping pattern in that after she became confused, she kept getting in and out of the bedroom through the night. She even became more confused while she was heading to the office, and according to the assessment, she has a poor appetite. All of the above symptoms show that Mrs. Smith’s mental status has changed.
The top differential diagnosis is Alzheimer’s disease. The first reason is that in Alzheimer’s disease, an individual begins to have memory loss that can disrupt daily activities (McCance & Huether, 2014). In this case, Mrs. Smith could not remember the names of her grandchildren, although she could remember her daughter. She could even ask what the children were doing in the house. Secondly, confusion with place and time, Mrs. Smiths got confused while she was heading to her office and even at night, and she kept getting in and out of the bedroom. Lastly, Alzheimer’s disease, poor appetite, and the history of Alzheimer’s disease in the family that is the husband had Alzheimer ’s disease. Click here to see a custom paper on Learners with emotional and behavioral disorders.
The patients suffering from delirium have difficulty in concentrating, poor appetite, insomnia, irritability, and restlessness. Delirium is caused by medical conditions such as thyroid disorder, renal insufficiency, hypoxia, urinary tract infection, and hypoglycemia and onset of delirium are acute (Lopes & Pereira, 2018). On the other hand, dementia causes the impairment of intellectual functions and disrupts memory, orientation, behavior, and language. Delirium presents itself with hallucinations, delusions, sleep disorders, and at times, loss of consciousness. Delirium is an insidious disease. Depression is a chronic disease that causes sadness and hopelessness in an individual. Depression causes a consistent change in mood, and it presents itself with insomnia, loss of interest, fatigue, gain or loss of weight, and insomnia. Patients with depression have suicidal thoughts and can quickly harm themselves or other people. The three diseases can be differentiated by performing a mental status examination, physical examination, and laboratory test of blood and urine. Click here to see a custom paper on Learners with emotional and behavioral disorders.
If all the investigations, including the mental status examination, physical examination, and MRI indicate, that Mrs. Smith has Alzheimer’s disease, which is a type of dementia. The education of the daughter about the disease is very crucial. The mother should be involved in a group therapy, which will help in controlling the behavior changes and in ensuring restoring function and accommodating lost abilities in her. According to (McCance & Huether, 2014), symptoms such as delusions, paranoia, and hallucinations should be treated using neuroleptic medications.
I would begin by asking a series of health history questions, accompanied by a medication list and any new changes in his lifestyle. Any recent increase in stress could be vital information. I would also ask about any recent injuries, the sequence of events preceding the seizure and lastly ask them to describe the seizure in detail.
Examination of this patient would be focused on his neurological status, cognitive skills, vital signs, and always rule out infection. Neurological examination is done, although it will provide evidence of the focal lesion under rare occasions. Delirium is majorly indicated by the impaired level of consciousness (McCance & Huether, 2014). In some cases, an altered level of consciousness or drowsiness can be observed after a seizure episode. In some other patient, seizures can be caused by a condition such as hypoglycemia, hypotension, and infections that affect the brain and causes an increase in the intracranial pressure. Click here to see a custom concept of brain disorders paper.
The necessary tests that would need to be performed or obtained specific to this case study include EEG, MRI, and some routine lab and urine tests. A urine drug screen and urinalysis can help rule out UTI and exposure to legal and illegal drugs that could cause issues (Fonseca et al., 2018). Routine blood tests should be done to rule out the causes of seizures such as hypoglycemia, electrolyte abnormalities, and infections. Electroencephalography (EEG) combined with a magnetic resonance imaging (MRI) will need to be performed to identify neural networks involved in an epileptic activity.
Lopes, R., & Pereira, B. D. (2018). Delirium and psychotic symptoms associated with hyperglycemia in a patient with poorly controlled type 2 diabetes mellitus. Innovations in Clinical Neuroscience, 15(5/6), 30–33.
McCance, K. L., & Huether, S. E. (2014). Pathophysiology (7th ed.). St. Louis, MO: Elsevier.
Fonseca Hernández, E., Olivé Gadea, M., Requena Ruiz, M., Quintana, M., Santamarina Pérez, E., Abraira del Fresno, L., … Toledo, M. (2018). Reliability of the early syndromic diagnosis in adults with new-onset epileptic seizures: A retrospective study of 116 patients attended in the emergency room. Seizure: European Journal of Epilepsy, 61, 158–163. https://doi.org/10.1016/j.seizure.2018.08.016