Neurointensivist @MUSCNeuroICU | Former Fellow @EmoryNeuroCrit and Chief Resident @MuscNeurology | Philly Sports Lover
Feb 13, 2023 • 20 tweets • 15 min read
1/ You're finally settled in as an attending and you get a new patient.
They sound brain brain dead.
They clinically look brain dead.
Your team asks if they're brain dead.
Well this turned serious… a quick #tweetorial about 🧠 death #NeuroTwitter#Neurocrit#MedTwitter2/ The transfer 📞 you got was a 28 yo with no other history. They were concerned about her being in status epilepticus.
You turn off all sedation. They're still unresponsive.
Jan 6, 2022 • 14 tweets • 9 min read
1/ There’s a lot of AEDs that work great together to tx szs! Unfortunately, Valproic acid (VPA) and Phenytoin (PHT) are two that didn’t get that memo.
Get ready for a fun and educational two-part #tweetorial on the do not miss VPA and PHT interactions w/ @theABofPharmaC2/ Let’s go back in time.
Valproic acid was first synthesized in 1882 by Burton. It wasn’t until 1963 when its anticonvulsant properties were discovered by Eymard.
Phenytoin was first synthesized in 1908 by Biltz and discovered to have anticonvulsant properties in 1936
The setup: Neuro ICU at @EmoryNeuroCrit
The pt: John Doe transferred for status epilepticus
You’re told about the pt’s ammonia lvl ➡️ 181 (where's @Capt_Ammonia?!). He’s also on 5 different AED’s...
@MedTweetorials #MedEd#tweetorial#neurotwitter2/ On quick review, patient was admitted 5 days earlier at the OSH. Initially admitted for encephalopathy that was then c/b seizures the following day. Initial ammonia was normal. CT/CTA unremarkable. MRI brain w/ contrast shows the following abnormality over the R frontal area
