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A 72 year old woman is brought to the ED by EMS after having altered behavior and inability to speak. She was preparing for bed when peculiar behavior was noted. The patient is unable to speak and is having unusual jerking movements. . The patient has no history of seizures. There is a history of
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1. Seizure Classification, Status Epilepticus Classification, and Emergent EEG J. Stephen Huff, MD, FACEP Emergency Medicine and Neurology University of Virginia Health System Charlottesville, Virginia
2. A 72 year old woman is brought to the ED by EMS after having altered behavior and inability to speak. She was preparing for bed when peculiar behavior was noted. The patient is unable to speak and is having unusual jerking movements.
3. The patient has no history of seizures. There is a history of stroke two years previously with residual mild right sided hemiparesis. There is no history of trauma. The patient has a history of hypertension for which she takes a diuretic.
4. On physical exam, her vital signs are blood pressure 120/80, pulse 90, respiratory rate 14, temperature 99, pulse oximetry 98% saturated on supplemental oxygen. She appears alert, eyes open, but is unable to speak. She does look towards the examiner when asked questions. The right side of the patient’s face, torso, and right upper extremity are having a continuous rhythmic motion.
5. Cranial nerves appear intact with the exception of facial twitching. The patient does not follow commands. Deep tendon reflexes are difficult to obtain because of movements.
6. Is this a seizure? What type? Status?
