Scenario

A 78-year-old man comes to your office with his daughter. The daughter reports that her father, Mark, has been confusing the name of relatives and is having trouble controlling his emotions. Her father was once a respected mathematician, but he is now having trouble completing simple calculations. He even claims that he does not know how to play the card game they have been playing since she was a little girl. She tried to get him to shower and put on clean clothes for the doctor’s visit, but he is adamant about the fact that he is clean. Most recently, he has had trouble recognizing people he has known for years. For quite some time, he has had trouble finding items such as his glasses or keys and his daughter attributed this to the natural aging process. Now she is not so sure.

Signs & Symptoms

• Mood swings
• Memory degeneration
• Noncompliance
• Short-term memory loss

Diagnosis

The diagnosis of patient 2 is Alzheimer's Disease. Our team came to this conclusion after eliminating other possible diagnoses. The patient displayed memory loss due to the fact that he forgot the game he used to play with his daughter. Mood swings are also a vital symptom in verifying Alzheimer's. When the patient was adamant about being clean, he refused external judgment thereby solidifying the diagnosis of our team. Since the patient had trouble with recognition of people he once knew, as well as with locating items, this provided us with the necessary information of the extent of his memory loss.

Treatments

• Cholinesterase inhibitors
• Memantine

Other Medical Referrals

• Neurosurgeon
• Physicians
• Psychiatrists
• Social Workers

Scenario

Andrew, a 45 year-old single father of two, comes to you in confidence. He’s noticed that the muscles in his hands and feet have gotten progressively weaker lately, and from time to time, he sees these muscles twitch. He used to lift weights at the gym quite a bit, but he now has trouble lifting the bar. His daughter noticed that he seems to be tripping and stumbling quite often and commented that it took him quite a long time to get the key in the door the other day. Andrew claims that mentally he feels fine, but it’s almost like his muscles are slowly giving out on him. You don’t see any twitches going on right now, but you are having a hard time hearing him. He seems to be having trouble projecting his voice and his speech is slightly slurred at times.

Signs & Symptoms

• Muscle Twitches (fasciculations)
• Muscle Atrophy (weakness)
• Loss of coordination
  • Tripping and stumbling often
• Dysphasia
• Slurred speech (disarthria)
• Trouble with projection of voice

Diagnosis

The diagnosis of patient 5 is Amyotrophic Lateral Sclerosis, also known as Lou Gehrig's Disease. Our team arrived at this conclusion because of the apparent symptoms and signs portrayed in the patient's behavior. For example, ALS patients commonly experience gradual muscle weakness.

Treatments

• No cure has been found
• Speech therapy
• Physical therapy
• Riluzole (Rilutek)
  • Slows ALS progression
  • Reduces levels of glutamate

Other Medical Professionals

• Physical Therapist
• Occupational Therapist
• Dietician
• Respiratory
• Social Worker
• Speech Therapist