In this episode of Critical Care Scenarios, Brandon Odo and Brian Bowling are joined by Dr. Casey Albin, a neurointensivist, to discuss a challenging neuro ICU case. The case involves a 49-year-old male with diabetes, hypertension, and a smoking history who was found unresponsive at home. The team discusses the initial assessment, differential diagnosis, and the importance of a thorough workup, including imaging, EEG, and lumbar puncture. They explore potential causes such as seizures, toxicological problems, and primary neurological issues like encephalitis. Dr. Albin emphasizes the need to consider autoimmune and paraneoplastic etiologies, detailing treatment strategies such as plasma exchange, steroids, and long-term immunosuppression. The discussion highlights the complexities of diagnosing and managing such cases, stressing the importance of a systematic approach and collaboration with specialists.
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