Where medicinethinks together.

A 74-year-old hypertensive male presents with a 2-year history of progressive cognitive decline. His deficits began abruptly after a lacunar infarct and have progressed in a stepwi…

A 35-year-old female with chronic migraine (> 15 headache days/month) has failed topiramate and amitriptyline due to side effects. She is now on overusing triptans. What is the cur…

A 58-year-old diabetic male presents with bilateral symmetric distal numbness, burning pain, and mild weakness of foot dorsiflexion. EMG/NCS shows predominantly axonal sensorimotor…

A 55-year-old woman with aneurysmal SAH (Hunt-Hess grade 3, Fisher grade 3) had successful coil embolization on day 1. On day 5, she develops new focal deficits and TCD shows eleva…

A 62-year-old man with newly diagnosed Parkinson's disease presents with mild resting tremor, rigidity, and bradykinesia but is still functionally independent. He asks whether star…

A 30-year-old male presents with ascending weakness starting in the legs, areflexia, and mild respiratory compromise 2 weeks after a campylobacter gastroenteritis. NCS confirms AID…

A 42-year-old woman presents to the ED with a sudden severe headache she describes as the worst of her life, with onset during exercise. No fever, no neck stiffness initially. How …

A 28-year-old female presents with bilateral optic neuritis and transverse myelitis extending over 3 vertebral segments. MRI spine shows a long central cord lesion at C3-C6. Serum …

A 35-year-old known epileptic presents with continuous tonic-clonic seizure activity lasting > 30 minutes unresponsive to IV lorazepam 4mg and IV levetiracetam 3g. He is now intuba…

A 67-year-old patient woke up with right-sided hemiparesis and aphasia. Time last known well is 9 hours ago. NIHSS is 12. MRI DWI shows small core infarct with large penumbra on pe…

25M presents to ED with fever 39.8°C, severe headache, neck stiffness, and photophobia for 6 hours. GCS 14 (E3V5M6). No focal neurological deficits. Petechial rash on trunk and low…

55M presents with progressive ascending weakness over 2 weeks. Started with bilateral leg weakness, now involves upper limbs (MRC grade 3/5 all four limbs), absent deep tendon refl…

42M admitted with refractory status epilepticus. Given lorazepam 4mg IV (2 doses), no cessation. Levetiracetam 60mg/kg loading dose given. Continuous EEG shows generalized electrog…

34F with chronic migraine (>15 headache days/month for >3 months, >8 migraine days/month). Has failed topiramate 100mg/day (poor tolerance — cognitive side effects), amitriptyline …

46M with tremor-predominant Parkinson's disease, newly diagnosed. MDS-UPDRS Part III score 28. Tremor is predominantly right-hand, mildly affecting his work as a software engineer.…