Rapid cognitive decline and myoclonus in a 52-year-old woman

[摘要] A 52-year-old woman presented to the emergency department in Las Vegas, NV, with progressively worsening altered mental status for the past 2 weeks. A history of symptoms was obtained from the patient’s sister, with whom she was staying. The sister reported that during the week before presentation, the patient had episodes of confusion, intermittent blank staring, blurred vision, bilateral incoordination of the upper and lower extremities, difficulty following commands, and decreased verbal communication. The patient had also been holding her left hand in a fist. Two days before presentation, the patient experienced a significant decline in mentation and had multiple episodes of urinary incontinence, which she never had before. During a period of lucidity in the emergency department, the patient denied having fever, chills, nausea, vomiting, chest pain, shortness of breath, abdominal pain, dysuria, or headache.

[学科分类] 卫生学