by Antonella Macerollo
Ebrain is a comprehensive e-learning platform for clinical neurosciences, with a broad range of content to support learning in a variety of ways. Of note, EAN members can access to Ebrain platform directly through their own EAN account page.
Over the last year, neurology residents from “the Country of the Month” selected for EANpages have contributed with a case report. Each report has been published in the eBrain platform as an interactive case.
Trainees have been asked to select clinical cases highlighting key diagnostic or management issues. Virtual interactive cases are presented starting with a clinical scenario, then offering choices about how to develop the diagnostic process, further investigate and manage the patients with feedback on good and bad choices through the case. Therefore, it is an effective educational tool to improve clinical neurology knowledge. Indeed, the cases include choices about what questions to ask next, what aspect of neurological examination to focus on, what investigations to request, treatment or ethical dilemmas. Obviously, learners can explore and re-run the cases as often as they wish.
We have included the abstracts of the cases published from different “Countries of the Month” over the last few months.
From May 2017 on, cases will be announced on a monthly basis in the “Education corner” of EANpages, with link to the eBrain website.
Directions: please log-in via the EAN-website and once you are on the eBrain page, go to “virtual patient cases”:
An unusual complication of general anaesthesia
Female patient, aged 60, without previous history of epilepsy developed no convulsive status epilepticus following general anesthesia. Clinically the patient presents with low level of consciousness, and left spastic hemiplegia. Initial brain MRI showed no signs of CNS damage. The EEG shows rapid delta activity consistent with non-convulsive status epilepticus. Treatment with valproic acid was started with substantial clinical improvement. A second brain MRI showed right parietal changes. Clinical signs, EEG and MGI showed substantial improvement within 1 month.
This case report explores fluctuating vertigo. The learner has the opportunity to deal with a patient who presents with vertigo and hemiparesis, with an occasional tendency to fall on the left during the previous fortnight. Otherwise fairly healthy. his condition has deteriorated in the past few hours and while conscious, he is now unable to communicate, has a drooping mouth, and an inability to feel pressure on his right limbs.
In this case report, the patient presents with a spinal mass lesion. Despite no relevant family medical history, for the past two years he has experienced vision and balance issues, and more recently he has been suffering headaches and dizziness.
Idiopathic Intracranial Hypertension
In this lesson, the learner finds a classic case of idiopathic intracranial hypertension. An obese but otherwise healthy female patient has a two-year history of continuous headaches, which have worsened steadily over time. A recent isolated incident of blurred vision in both eyes lasting a few minutes has prompted her to seek medical attention.
Intracranial Mass Lesion
This case covers an instance of intracranial mass lesion. A previously fit mid-fifties gentleman presents with a recent right hemiparesis. A twenty-year smoker, he has also experienced substantial weight loss during the previous weeks.
A tricky enhancing cerebral mass
This case takes the learner through the history and presentation of a rare intracranial lesion. In his early seventies, a patient has experienced recent worsening leg weakness to the extent that now he cannot stand. No relevant medical history, no relevant medication, he is a non-smoker with no weight loss, shortness of breath or cough.
Oncology Pushing the Limits
This case takes the learner through the various treatment options of a case of cerebral metastasis. A male patient presents with a right hand weakness which has developed over a few days. No other relevant medical history, besides that two years previously he underwent an oesophagectomy for an adenocarcinoma of the esophagus.
Cystic Temporal Tumour
This case examines an unusual presentation of a tumour in a young man. Referred by a neurologist, he has been diagnosed with temporal lobe and prescribed carbamazepine for a previous seizure. He describes a three-year history of voices talking to him in the third person, primarily male, but occasionally female. Otherwise, his neurological exam is normal.
A Parasellar Lesion
This case explores the history and presentation of a parasellar mass lesion which presents acutely. A mid-fifties female patient reports sudden onset of severe headache. Initially treated successfully by analgesics, she has recently lost some vision in both eyes, causing her concern. She has no relevant family medical history, she does not take medication, and is a non-smoker.