Write a description of the health history you would need to collect from the patient in the case study to which you were assigned.
The assessment of a patient with any suspected neurological disorders should be widened as much as possible to cover the overall degree of possibilities and thus offer the medical team a consistent set of information and data that can be linked to the clinical tests without any inconsistencies (Jarvis, 2015). The patient’s health history forms a significant background on which this can be achieved. For this 33 year old patient, the care team has to inquire about any past and present medical problems that she may have had such as atrial fibrillation, recurrent miscarriages or diabetes mellitus. An inquiry of her reproductive health including neonatal health, pregnancy and delivery as well as the possibilities if any infections, injuries or convulsions in their childhood or infancy may provide substantial evidence of the primary problem (Jarvis, 2015).
Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis.
There are several tests that can be utilized to help make the diagnosis in this case. These would include Computed tomography scan of the head, Lumbar puncture, Test for vitamin B 12 blood levels as well as Magnetic resonance image (MRI) of the brain (Fuller, 2013). The CT scan as well as the MRI scan offers detailed information on the status of the brain in terms of injuries, damage, and the presence of tumors as well as detecting any skull fractures all which can offer a clue to the illness manifested by the patient (Talley & O'Connor, 2013). A test for vitamin B 12 blood level on the other hand would provide the care team with information in regard to the health of the brain considering that Vitamin B12 plays a key role in the development of the brain. Low levels of Vitamin B12 would apparently indicate that this is the primary cause of the symptoms being manifested by the patient since a little dysfunction of the brain has a magnified effect on the neurological system. The lumbar puncture on the other hand is a test that involves the collection of the cerebrospinal fluid for testing to ascertain the presence of any diseases of the central nervous system such as meningitis or subarachnoid hemorrhage (Aminoff, Greenberg & Simon, 2015).
List five different possible conditions for the patient's differential diagnosis, and justify why you selected each
Bell’s palsy: This is a condition that causes a paralysis or weakness of the facial nerve or the 7th cranial nerve that serves the facial muscles. When this nerve is affected, the facial muscles become irresponsive and could present as weak and drooping face. It may occur suddenly in most cases or gradually extend across the face with time if not managed (Fuller, 2013).
Ischemic stroke: Ischemic stroke on its part occurs when a particular artery has been blocked by a blood clot and thus leading to a dysfunction of the region served by that artery. The fact that such an artery that is affected could be one that supplies blood to the right side of the face implies that the body organs and cells in that region will gradually lose their functionality and present in the manner of a weak section of the body such as a drooping face (Fuller, 2013).
Brain tumor: Brain tumors are general abnormal growths within the brain and they could extend to the nervous system or even cause a blockage of the vital elements of the nervous system. With the nervous system affected, the [possibility of weaknesses on a particular region of the body is high (Fuller, 2013).
Trigeminal neuralgia: This condition could be a possibility since it affects 5th cranial nerve or the trigeminal nerve which is highly distributed across the face and a dysfunction of this nerve could present as a drooping of the face as reported by the patient.
Hemiplegic migraine: This condition causes a temporal weakness on one side of the body and this can be the face or the arms or even so the lower extremities. This weakness can present with numbness as well as pain on the affected region (Aminoff, Greenberg & Simon, 2015).
References
Aminoff, M., Greenberg, D., & Simon, R. (2015). Clinical Neurology 9/E. McGraw Hill Professional.
Fuller, G. (2013). Neurological examination made easy. Elsevier Health Sciences.
Jarvis, C. (2015). Physical examination & health assessment (7th ed.). St. Louis, MO: Saunders/Elsevier.
Talley, N. J., & O'Connor, S. (2013). Clinical examination: a systematic guide to physical diagnosis. Elsevier Health Sciences.
