The Clinical Problem Solvers Episode 412: Schema Episode – Seizure, Fever, Encephalopathy
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Aug 7, 2025 Dive into an intriguing clinical case featuring a 54-year-old male with new-onset seizures and fever. The team explores critical diagnostic challenges and management strategies, particularly in the context of severe hypoxia and neurocritical care. Discussions illuminate the complexities of diagnosing CNS diseases, including meningoencephalitis and cryptococcal infections. Personal anecdotes about favorite shows and emotional milestones add a light-hearted touch to the intense medical insights, making for both an entertaining and educational experience.
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Patient Presentation with Status Epilepticus
- A 54-year-old male with no prior medical history presented with new-onset seizures and fever, found down unresponsive with left-sided jerking movements.
- This acute presentation raised suspicion for status epilepticus requiring urgent management.
Stepwise Status Epilepticus Management
- Manage status epilepticus first with benzodiazepines, followed by anti-seizure medications if seizures persist.
- Always assess airway protection and prepare for intubation if seizures become refractory.
Meningoencephalitis Focused Differential
- Neuroimaging showed meningoencephalitis with hydrocephalus and dural involvement indicating a severe CNS infection.
- These findings focus the differential diagnosis on infections causing both meningitis and encephalitis.