Mr. A.H., age 44, had a generalized tonic-clonic seizure unexpectedly at work. He had no history of seizures, trauma, infection, or other illness. Investigation revealed a tumor in the right parietal lobe. This was removed surgically, although the diffuse nature of the malignant mass prevented its complete elimination. Follow-up radiation treatment was recommended.

1. Describe briefly several diagnostic tests that would be of value in this case.

2. Explain the basis of this seizure activity, and describe how it might be controlled.

3. Describe each stage, in sequence, of a generalized tonic-clonic seizure.

After surgery, Mr. A.H. demonstrated considerable weakness and sensory loss on his left side.

4. Match each of these effects with the functional areas of the brain that control them

A few days after surgery, Mr. A.H. developed a bacterial infection at the operative site.

5. Explain why this infection is likely to increase motor and sensory deficits.

The infection was eradicated quickly with treatment, but the tumor did not respond to radiation and chemotherapy. As a result, several tumors in the brain grew relatively large during the next 2 months.

6. The cancer treatments caused severe anemia, nausea, and vomiting. Explain how these side effects could cause other complications for Mr. A.H.; describe these complications clearly.

7. Suggest several types of therapy or assistance that would be helpful to Mr. A.H. during this period. (Extend this question to focus on your specialty area, when possible.)

Mr. A.H. developed severe headaches and diplopia and became increasingly lethargic, and his seizures increased in frequency despite anticonvulsant medication. He was given medication to reduce the frequency of vomiting.

8. Explain the specific rationale for each of his manifestations

As the tumors increased in size Mr. A.H.’s vital signs indicated increased pulse pressure.

9. Explain the cause of each of this sign.

10. Describe the changes that are likely to occur as coma develops in Mr. A.H.

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