Guess Ted Kennedy's diagnosis

Discussion in 'Clinical Rotations' started by ForbiddenComma, May 17, 2008.

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What is the cause of Ted Kennedy's seizures?

Poll closed Jun 16, 2008.
  1. Stroke or TIA

    12 vote(s)
    16.0%
  2. Neoplasm, such as GBM

    26 vote(s)
    34.7%
  3. Hypoglycemia or other metabolic derangement

    6 vote(s)
    8.0%
  4. EtOH related (DTs, Korsakoff's)

    17 vote(s)
    22.7%
  5. Febrile sz

    0 vote(s)
    0.0%
  6. Neurodegenerative / dementia

    0 vote(s)
    0.0%
  7. Pure epilepsy (new-onset or previously diagnosed)

    2 vote(s)
    2.7%
  8. Addison's

    1 vote(s)
    1.3%
  9. Psychogenic / conversion disorder

    0 vote(s)
    0.0%
  10. It was syncope, not a sz

    8 vote(s)
    10.7%
  11. Other (explain below)

    3 vote(s)
    4.0%
  1. ForbiddenComma

    ForbiddenComma Tanned for Bowling
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  2. BogglestheMind

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    They will do a diffusion weight MRI for sure given his high-risk status post CEA, however, I think they he may had had a seizure as this is usually made 110% via history and if someone is saying seizure there likely was seizure related components like tonic-clonic movements, etc . . ., especially since he is OK apparently now it was not a major stroke, although TIA is possible, . . . I think he had an ethanol withdrawl seizure which usually occur within 48 hours of drinking, this is supposing that he became very intoxicated on Friday night (as Teddy has been known to do), . . . given this time frame too early to say DTs, . . . I would guess he was celebrating that his endorsement of Obama way back months ago was probably enough to in the end knock Hillary Clinton out of the presidential race (this became apparent recently to the majority of sentient beings in the US and makes Teddy look good that he pick the right horse in this race) . . . hope he recovers, can't wait to see him on C-SPAN hugging H-Rod when she gets back to the Senate, "Eh, hows it going Hillaary, too bawd about the nomination, sorry your husband is such a red neck otherwise we, eh, Kennedys could hev supported 'em and you." Hopefully later this week he'll be back at the compound eatin' clam chowda
     
  3. MOHS_01

    MOHS_01 audemus jura nostra defendere
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    where is the box for "who gives a f***"? or "does not f*ing matter as long as it leads to retirement"?

    I hope that he is OK, but I would celebrate his and Diane's retirement.................
     
  4. soeagerun2or

    soeagerun2or Membership Revoked
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    Does hepatic encephalopathy fall under EtOH related? Otherwise I would go with a combo of EtOH related metabolic (hypoglycemia) or possible TIA 2o HO CEA.
     
  5. velo

    velo bottom of the food chain
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    This option wasn't really up there, but adults can have an isolated idiopathic sz and not have 'epilepsy' (i.e. no recurrent szs, no need for anti-convulsants) and while it's certainly prudent to search for all the possible secondary causes of his seizure (like the one's you mentioned) if you took 100 people with cases like Sen. Kennedy's then this explanation, isolated idiopathic sz, would be the most common.
     
  6. Scaredshizzles

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    It might be a common diagnosis, but I don't think it is usually the correct diagnosis. Seizures become more common again in old age for good reasons, such as mild-moderate cerebral atrophy.

    Based on some of the statements that he is not in immediate danger, I'm guessing it is not a GBM, but otherwise it would be high on my list....

    Dementia related repetitive seizures of the GTC variety usually occur late in dementia, so while I tend to think he is getting a little senile, I don't think it would be a good diagnosis.

    I'd have to say if it were alcholol related, knowing the Kennedy family, they probably would have found a way of keeping it hush hush.....Metabolic derangements leading to seizures usually occur in either malnourished/alcoholics/frail elderly persons who sometimes don't have the energy to eat, or young women who are borderline anorexic.

    So I voted for isolated seizure as well, but at the least I'm guessing there is slight anatomical/atrophy issue.

    Also global ischemia from a stenosed carotid can cause seizures without necessary prolonged stroke symptoms.

    And post-syncope can also have tonic-clonic type of movements, but usally last only 10-15 seconds without a post-ictal state. The news accounts make it seem like he was definitely still altered post seizure, perhaps Todd's paralysis which is fairly common.
     
  7. PlasticMan

    PlasticMan Senior Member
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    Post traumatic stress disorder after witnessing a drowning. :smuggrin:
     
  8. Kubed

    Kubed Mostly Harmless
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    :laugh: ZING!
     
  9. velo

    velo bottom of the food chain
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    Ok, well, 6 of one half a dozen of the other, point is that commonly a first time seizure in an adult is isolated, not related to a secondary cause, and does not require long term treatment. I'd especially favor that diagnosis given the fact that we haven't heard much about other symptoms that would point us towards any of those secondary causes. I'm sure he'll get a pretty extensive w/u to rule those out and that's probably appropriate in this case.

    Your point about cerebral atrophy creating substrate for seizure activity is well taken, but given the current state of understanding I still don't think 'isolated idiopathic' is that bad of a term to slap on this kind of thing.
     
  10. Scaredshizzles

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    I'd be curious as to what the percentage differential on it is actually...Where I am at, a seizure work up in an elderly patient usually does (seemingly) be secondary to something....But there is a lot of HIV, DM2, and CV risk factors where I am too, with hypertension being present in about 80% of people over age 60 that you actually see in the hospital... So the presence of ischemic events and abscesses and significant cortical atrophy are probably a lot more common here than in the general population. As is perhaps the rate of brain tumors that first present as seizures because more subtle neurological deficits or whatever aren't picked up in patients with less access of primary care physicians/less educated about their own health, etc.
     
  11. Tiger26

    Tiger26 Senior Member
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    I was just going to mention Wernike--Korsakoff, but I think your dx was a little more pointed

    *For all, you kids, just make sure that you never get in the car w/the Tedster
     
  12. Soundwave

    Soundwave Decepticon
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    I think that it was definiteliy alcohol. The whole kennedy family is full of nitwits that have no business in public office.
     
  13. silas2642

    silas2642 silas2642
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    fatdrunkwhitemanism
     
  14. ForbiddenComma

    ForbiddenComma Tanned for Bowling
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  15. RussianJoo

    RussianJoo Useless Member
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    Yep GBM is the answer.. congradulations to the winners.
     
  16. DrDre311

    DrDre311 Makaveli
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    Whatever your politics, cancer is a horrible disease. Senator Kennedy and his family should be in our thoughts.

    I can't imagine how hard it would be to grow up in that family: public spotlight, JFK & RFK assassinated, JFK Jr. killed in that plane crash, political weirdness all about, now Uncle Ted with what amounts to a death sentence...
     
  17. Tired

    Tired Fading away
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    I heard it was a high-grade glioma, which is not necessarily a GBM.


    Gotta admit, when I first heard that Ted Kennedy had a malignancy in his brain, all I could wonder is how Karl Rove's entire fat a$$ got in his skull.
     
  18. superoxide

    superoxide Member
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    :laugh:
     
  19. RussianJoo

    RussianJoo Useless Member
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    hey i wasn't the one who created the thread.. I feel sorry for Ted as well. I was just trying to point out how stupid this thread is.
     
  20. RussianJoo

    RussianJoo Useless Member
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    i thought it i saw on CNN and Fox news that it was GBM and then they had some doctor comment how it's the most common adult brain tumor and how it's also the most aggressive.
     
  21. DrDre311

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    Wasn't picking on you. I didn't realize I'd quoted you until now.
     
  22. Scaredshizzles

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    High grade glioma could be a malignant astrocytoma also, but that is a more rare diagnosis.

    WHO keeps going back and forth on whether to even differentiate malignant astro from GBM...In fact GBM is no longer the correct term, GBM now is simply called "glioblastoma", the multiforme has been dropped.
     

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