Altered Mental Status

53 year old with a new diagnosis of lung cancer, evaluate for metastatic disease. Otherwise no additional symptoms, Non focal

62 year old presents to the ER with new onset word finding difficulties and facial weakness; 3 days prior to presentation she was having difficulty finding the correct words when she was typing on a computer. The following day, she noticed that she was drooling from her mouth. Slurring speech and struggling to produce words. She could not remember her own date of birth or her physician’s name.

Physical Exam: Was having a difficult time finding words. Right Facial Droop involving the lower half of the face,

60 yo with right upper > lower extremity weakness for 3 months.

62 yo with right hand weakness which began 10 days ago; dropping items; also feels numb

Tremors

40 lb weight loss; fatigue; nausea, frontal headaches

Recently quit smoking- 40 pack year

32 year old with a history of IV drug abuse. Presented with AMS and possible seizure like activity.

19 year old with 2 concussions in the past 3 weeks; Soccer injury. Now presenting with dizziness and slurred speech.

Otherwise non focal exam

49 year old with acute onset of right eye pain and optic disc edema on physical exam.

22 yo with intermittent headaches over the past month, acutely worsening over the past 36 hours. Headaches are constant; No aura; Initially presented to an OSH ER had CBC WBC 11. Strep and Influenza were negative.

CT was done– reportedly normal. Morning of presentation, she had a tonic/clonic seizure lasting 10-15 minutes. EMS called. Seized 4 more times on her way to the ER.