45

45 CASE 45


A 19-year-old college student comes to student health services complaining of sporadic loss of memory.


The periods of amnesia occur while the student is awake and occasionally in class. During those times, his classmates report that he begins smacking his lips and fumbling around, disrupting the class. When confronted by his teacher, the student has no recollection of those events and was confused and disoriented. He rests for about 30 minutes and then feels fine. There is no family history of seizures. The student did suffer a head injury while playing sports 6 months earlier, but he does not indicate any cognitive defects.



PHYSICAL EXAMINATION



VS: T 37°C, P 76/min, R 18/min, BP 118/76 mm Hg

PE: No abnormalities noted


LABORATORY STUDIES



EEG: Normal

MRI: Normal


DIAGNOSIS


Symptomatic epilepsy



PATHOPHYSIOLOGY OF KEY SYMPTOMS


This patient’s symptoms are tied to abnormal function of the central nervous system. Inability to remember activities (amnesia), disorientation, and confusion indicate a disruption of the higher cognitive processes.


Synchronized activity of neurons of the brain generates waves of electrical activity that can be recorded as an electroencephalogram (EEG) by surface electrodes on the scalp. The frequency of these brain waves varies based on the level of coordinated neuronal activity (Fig. 45-1).


image

FIGURE 45–1 Different types of brain waves in the normal electroencephalogram.

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Jul 4, 2016 | Posted by in PHYSIOLOGY | Comments Off on 45

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