Episode 220: Neurology VMR – Drowsiness
The Clinical Problem Solvers
The Clinical Problem Solvers
4.7 • 528 Ratings
🗓️ 26 January 2022
⏱️ 61 minutes
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| 0:00.0 | Hey folks, just a quick reminder that this episode is not meant to be used for medical advice, just good old-fashioned education. |
| 0:08.5 | All patient information has been modified to protect their identity and the views expressed in our podcast do not necessarily reflect the opinion of our employers. |
| 0:28.5 | Perfect. So the chief concern is going to be increased drowsiness. |
| 0:37.1 | Increased drowsiness. Okay. Matia, you're about to be a neurologist in training here. |
| 0:39.7 | You hear increased drowsiness on the page, you think just two words, what am I supposed to do with this? But as you get your hammer and |
| 0:44.6 | things into your white coat pocket and go to do one of your first consults, what's running through |
| 0:48.7 | your mind here with this chief concern? Yeah, I think it's a fascinating and kind of vague chief concern. So, you know, |
| 0:56.7 | in neurology, we always think about the timing and the localization, and we kind of have neither here. |
| 1:04.1 | Now, I'm thinking that the timing will be everything here, but just to start, I think that in terms of localization, |
| 1:14.0 | we should not forget that drowsings can be caused |
| 1:16.2 | by pretty much anything in terms of systemic things. |
| 1:19.5 | You know, it can be something hematological. |
| 1:22.2 | It can be something like the cardiovascular system. |
| 1:24.9 | It can be something related to the lungs, you know, if they have |
| 1:29.1 | COPD, they're hypercarbic, hypoxic, and so forth. So I think it's important not to forget |
| 1:36.7 | those things. Now, in terms of localization, we did the Norexis. Of course, drowsiness, we know that it localizes mostly to the cerebrum, |
| 1:47.2 | although most, if we're thinking of drowsiness as impairment of awareness or consciousness, |
| 1:54.9 | then it would localize either to the whole cerebrum, to both hemispheres, or to the Talamai, or to the R cerebron to both hemispheres or to the thalamide or to the to the r a s s right the palms essentially |
| 2:08.9 | so that's a thought now what can impair both hemisphere either they're having a massive stroke that |
| 2:16.4 | affects everything a basilar infarction, something like that. |
| 2:21.7 | Or we could think if it's more of a sub-acute problem, we could think of something toxic metabolic. |
| 2:28.4 | Can we go back to our hypoxia and hypercarbia and drugs and so on and so forth. |
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