An 11-year-old Female With Altered Mental Status, Speech Changes, and Abnormal Jerking Movements

A 16-year-old boy with altered mental status.

and colleagues discuss hard-to-diagnose cases. A 16-year-old boy was transferred from an outside hospital for evaluation of altered mental status. Earlier in the month, he had begun having feelings of nervousness and anxiety. He reported hearing voices and having visual hallucinations. According to his parents, these symptoms had begun after the patient had been out clubbing with his friends; h...

Photo quiz: A 58-year-old female with altered mental status.

A 39-year-old man with acute mental status changes.

The incidence of herpes simplex virus (HSV) encephalitis exceeds that of other forms of acute viral encephalitis. It is widely acknowledged that the use of PCR amplification for the detection of HSV DNA in cerebrospinal fluid (CSF) has increased our diagnostic sensitivity for this illness, leading to the diagnosis of HSV encephalitis in a wide range of clinical presentations. It is important to...

An 8-year-old boy with Fever, axillary ulcerative lesion, and altered mental status.

Figure 1. Left axillary lesion Figure 2. Wright stain of the patient's CSF sample, revealing 87% lymphocytes (including many atypical lymphocytes) and 13% neutrophils. Diagnosis: tularemia with meningitis. After the lumbar puncture was performed, intravenous cef-triaxone was added to the patient's vancomycin therapy, and later that day, treatment with intravenous doxycycline and gen-tamicin was...

Pediatric Absence Status Epilepticus: Prolonged Altered Mental Status in an 8-Year-Old Boy

Absence status epilepticus is characterized by a prolonged state of impaired consciousness or altered sensorium with generalized electroencephalographic abnormalities. It is most commonly diagnosed in patients with known idiopathic generalized epilepsy; however, it may also be the first presentation of epilepsy. Due to the subtle and variable manifestations of the condition, absence status epil...