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Human Clinical Science - Essay Example

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Case Study 1 1. The most likely diagnosis for this patient is he has epilepsy associated with complex partial seizures developing into secondary generalized tonic-clonic seizures. In complex partial seizures, there is a loss of consciousness but the symptoms of the seizure are fairly mild, as seen in this patient…
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Download file to see previous pages Seizures can also be caused by fever, in which case they are known as a febrile seizure. There are also infectious causes, such as meningitis or tapeworm. In the case of this patient, it appears that the DPT vaccine caused a fever, which led to a febrile seizure. This is rare, but can occur (Griffin et al, 1990). In many cases, patients will only have one or a limited number of febrile seizures. However, this patient has first- and second-degree relatives with related conditions, and this increases the chances of developing epilepsy (Griffin et al, 1990), which means that it could have been triggered by this initial event. 3. The information from the family history is useful because epilepsy does not normally develop from febrile seizures unless there is a family history of epilepsy or seizures (Brodie et al, 2009). In this case, there is, and therefore it is evident that there is some genetic component playing a part in the seizures discussed in this case study. 4. The most reliable way of diagnosing any form of epilepsy and categorizing seizures is to use an EEG. EEGs pick up electrical signals from the brain and represent brainwave patterns, and if these are different from normal values then this can indicate epilepsy. It is helpful to do this during a seizure to identify what type of seizure is occurring, so a seizure may need to be provoked to correctly identify whether this is a tonic-clonic or other form (Engel et al, 2008). In this patient, we would expect to see focal activity during the initial stages of the seizure, followed by extreme brain activity during the tonic-clonic stages. 5. The parents of the patient should be advised to lie the patient down away from any objects that may cause harm during a seizure. If the floor is hard, it may be worthwhile putting the patient or a blanket. Turning the patient on his side may help to prevent him biting his tongue or swallowing any vomit. 6. There are a wide variety of treatments for epilepsy. If it occurs during a fever, as in the case of the first seizure of the patient, it may help to reduce the fever. There are also a number of anti-epileptic drugs which are useful in about 70% of patients and can help keep them under control completely. Surgery is a last-resort option and can be done in extreme cases. A ketogenic diet can also be advised and can be helpful in many cases of childhood epilepsy. This type of diet is high in fats and low in carbohydrates and protein and may make seizures less likely by altering the chemical composition of the brain (Theodore & Porter, 1995). As stress is sometimes associated with epilepsy, it may be worthwhile to ensure that the child is kept away from stressors and perhaps when older meditation or relaxation therapies may help to prevent further seizures (Brodie et al, 2009). Case Study 2 1. There are a number of disorders associated with the symptoms that Katherine is presenting with. However, systemic lupus erythematosus (SLE) is associated with fatigue, migraine, and has been associated with some skin conditions (Buyon, 2008). It is also associated with pain which occurs mainly in the joins (Buyon, 2008), as seen in Katherine’s case. It would also account for the slightly elevated blood pressure that Katherine exhibits. Some studies have shown that it can be triggered by the Epstein-Barr virus, which may explain why the symptoms began after an infection described as ‘ ...Download file to see next pagesRead More
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