Case Study Delirium in an Adolescent Girl With Human 在一个有人的青春期女孩的案例研究.ppt

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2016-12-30 发布于上海
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Case Study Delirium in an Adolescent Girl With Human 在一个有人的青春期女孩的案例研究.ppt

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Case Study: Delirium in an Adolescent Girl With Human Immunodeficiency Virus-Associated Dementia Michelle Lisk Background Info Female 15 years old History of HIV infection From the inner city of Baltimore Problems HIV virus in its late stages causes development of HIV-associated dementia (HAD) Fevers incited bouts of delirium due to her current condition of HAD The top row of images are of the patient The bottom row of images were taken of a normal 16-year-old Damages Overall thinning of the corpus callosum Prominent ventricles and sulci Signal abnormalities were observed in the right caudate nucleus Extensive cerebral atrophy Examination 3 Years Prior Preformed in the 93rd percentile in adaptive behavior skills tests Talkative and able to carry on reciprocal conversation No reported disruptions in thinking, behavior or skills Normal motor functioning, posture and gait Vineland Adaptive Behavior assessment showed patient to be in the first percentile for adaptive functioning Could recall names of people around her, but conversation was empty and non-reciprocal. Also exhibited speech latency when responding to a question. Easily agitated and physically aggressive Displayed resting tremors and a decline in posture and gait Current Examination(After treating the episode of delirium) Discussion Severe cognitive decline is most likely caused by marked cerebral atrophy Damage to the right caudate nucleus could explain the lack of response to the attempts to restrain and calm the patient Lack of attention and inability to maintain productive conversation is likely due to the thinning of the corpus callosum Interestingly, the patient showed no deficits in IQ knowledge as compared to earlier scores suggesting her long-term memory was relatively in tact Outlook The acute episode of delirium was treated on site HAD currently has no cure The best treatment for HAD is highly active antiretroviral therapy to attempt to slow down the process of atrophy Patient has