044. Diagnosis

[vicodincrutch]

DIFFERENTIAL DIAGNOSIS

SYMPTOM(S): Uncontrollable Laughter
                          Chest Pain
                          Clumsiness
                          Which caused cranial bleeding.

POSSIBLE DIAGNOSIS:
Amyotrophic Lateral Sclerosis--it explains the chest pains, clumsiness and the laughter. The curse is accelerating the effects the degeneration

Comments

[eduronox]

It sounds closer to Creutzfeldt-Jakob disease than Sclerosis. Neither are so fast-acting. Some kind of advanced prion infection, potentially.

Kuru would explain the laughter and nerve degeneration.

[vicodincrutch]

The laughter is the main symptom. He hasn't been to New Guinea or had brains recently.

...But that would make sense. Dementia being one of the leading symptoms and the laughter as a branch off from that. An MRI and some brain fluid samples would rule that out.

I want to treat the dementia for now to make him shut up.

Great now I want to watch Indiana Jones AND One Flew Over the Cuckoos Nest.

[eduronox]

It is not simple exposure nor brains that transmit Kuru, but ingestion of infected matter. It is cultivated by excessive cannibalism but can be extracted and implanted in just about anything, accidentally or otherwise. "Mad cow disease" is a notable variant.

Can the patient be coaxed to sleep naturally, or with a mild sedative? Prion infections make the brain highly unstable, treating dementia if prematurely misdiagnosed will only cause further irreparable brain damage.

[vicodincrutch]

Sorry, I was caught up in the romanticism of eating people. That must have been one angry cow.

Logically, this much laughter would have caused a syncope. It hasn't. So much for naturally. I wasn't thinking of treating the dementia without the MRI. The thought of gagging him was getting to be appealing too.

It's relatively early into CJD, if that's what it is. The dementia has no bite.

[eduronox]

I don't see the harm in gagging anybody, as long as their airway isn't restricted.

In that vein, there's always Gerstmann-Sträussler-Scheinker syndrome, but it's familial, and even more rare than Kuru. So is the fatal insomnia. It's not something that comes up in a usual family medical screening, but worth looking into.

The laughter without syncope side effects is notable, which makes me believe Kuru - pathologic uncontrollable laughter. While these infections are fatal and without known treatment, prions themselves can be reverted with exposure to intense heat - nearly three hundred degrees Fahrenheit if memory serves - for twenty minutes or so. It would kill a human to incubate a fever of even half that intensity.

[vicodincrutch]

That's what noses are for.

He's to boring to be cooked at that temperature. That's not something to rule out. He's got a girlfriend in the City so he has been sleeping and he has been sleeping.

[eduronox]

That is not the sort of fever that will do anybody any good.

[vicodincrutch]

I don't think he's that hot to tell you the truth. Maybe an 6 or high 7 at tops.

[eduronox]

I'm sure he's charming.

But did he eat anything contaminated, is the question.

[vicodincrutch]

Answers are hard to get out of him. He's a growing boy, likely he had beef. Someone else infected with the same symptoms had roast beef.

[eduronox]

Vague at best.

Mild sedatives and restraints, if the condition worsens.

It would be negligent to wait until midnight to begin testing.

[vicodincrutch]

Yeah. I got that.

The MRI is getting ready. I'm not neglectful and I want to know if this is right.

[eduronox]

Good for you.

Transmissible spongiform encephalopathies are difficult to work with. If you're working with a technology level that relies on MRI machines...

Hopefully he's just hit his head.

[vicodincrutch]

Busy bodies who don't introduce themselves and assume a medical authority are difficult to work with too. I manage just like I do with spongiform encephalopathies.

An MRI should do it. I left my lightsaber at home.

He didn't. I asked. No signs of concussion or spinal swelling.

[eduronox]

Men who are familiar with prion pathogenic theory require introductions?

Unfortunate. I have my wand. I am otherwise occupied, however. As fascinating as observing the process sounds, I have idiots minors in my care.

[vicodincrutch]

Only if they have any manners. It doesn't sound like you.

Prom will do that to you. Have fun screwing up make outs.