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Washington University Experience | MYELIN (IMMUNE-MEDIATED) | MS - Cerebral Hemispheres | 13A0 Case 13 History
Case 13 History ---- The patient is a 40 year old man with a past medical history of relapse remitting/secondary progressive multiple sclerosis (diagnosed 2006), epilepsy (diagnosed 2009), and a left temporal lobe grade II “oligoastrocytoma” (diagnosed 2010) status-post chemotherapy started on July of 2010 and stopped in March of 2012 due to seizure complications. Salvage chemotherapy with Avastin and carboplatin was initiated in March of 2013 following an MRI showing tumor progression. His chemotherapy was discontinued due to infection risk. He subsequently entered hospice care in November of 2013. In January 2014 he was admitted to our hospital for seizures refractory to home treatment. He was found to have a low grade fever with coarse lung sounds bilaterally. A head CT demonstrated mild cerebral atrophy. He subsequently was diagnosed with status epilepticus and was placed on an Ativan drip and given a nasogastric tube for feeding. Over his hospital course he remained unresponsive and obtunded followed by the progressive development of labored breathing, tachypnea, tachycardia, and worsening fevers. He was found unresponsive without heart sounds in early January 2014.
