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 process of the disease, usually it's a lot more slow. Search for DNA abnormalities or any hereditary link.

Pseudobulbar palsy onset by a tumor in the high brain stem or motor neurone diseases that would cause the disorder int he brain stem and spinal column.

Dementia (scribbled in) by Kuru causes the laughter as well as the inability to cooperate. The laughter would be causing the chest pains all the way down to clumsiness if that's the case.

CJD-?

The first two are not entirely treatable. A sample of tricyclic antidepressants would rule out dementia.

[ooc;  Curse or not, he'd want to diagnosis this. Since House is kind of an investigatory doctor, for nowit is just ruling out different diagnosiseses since tomorrow is OH SNAP THIS ISN'T NORMAL day. Any questions, comments or things I shouldn't be doing plz do AIM me. That's why God LJ made edits.]

Comments

[eduronox.livejournal.com]

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.

[lyra-of-dust.livejournal.com]

A lot of people seem to be sick with it.

[vicodincrutch.livejournal.com]

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.

[vicodincrutch.livejournal.com]

I'm getting sick with it that's for sure.

[lyra-of-dust.livejournal.com]

People laughing, people throwing up... I dunno if this is a curse or not.

[vicodincrutch.livejournal.com]

Well, one way to find out is waiting for midnight. Until then, I want to know if I'm right.

Drink some orange juice and wash your hands.

[lyra-of-dust.livejournal.com]

I know, I know... Seems like different people are sick with different things though.

[vicodincrutch.livejournal.com]

That's a possibility. Or they all have various strains of the same mondo sickness.

[lyra-of-dust.livejournal.com]

Mondo?

[eduronox.livejournal.com]

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.livejournal.com]

Big boss, head honcho, big ass...?

[holymadonna.livejournal.com]

If the patient suffers from dementia, the anticholinergic properties of the tricyclic antidepressants would worsen their state. Are you taking such huge risk, Doctor House?

Do we have a psychiatrist who can successfully run the Mini-Mental Status Examination?

[vicodincrutch.livejournal.com]

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.

[vicodincrutch.livejournal.com]

I only want him to shut up, Mom. Working on an alternative and a new diagnosis. A friend came over to play.

Contrary to popular belief, I don't know any shrinks. We used to have one somewhere.

[eduronox.livejournal.com]

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.

[hercount.livejournal.com]

You are hypothesizing the City is giving genetic disorders as a curse?

*voice post*

[eternalnic.livejournal.com]

Have you had any...*hehehe* progress made on this...?

*gasping and then more laughter*

I think I might have *deep throaty laugh followed by a gasp and then giggles* the same illness.

[vicodincrutch.livejournal.com]

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.

[holymadonna.livejournal.com]

Where did you find him, son? What about laboratory tests and samples? Do we have one? I think we should begin there before medicating him and if he has or not taken high doses of alcohol or drugs. Introduce me to your friend.

Doctor Lecter had opened a psychiatrist when he was in the City, but it closed down once he left.

[vicodincrutch.livejournal.com]

If it can temporarily give a person breasts, why not?

[eduronox.livejournal.com]

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

[vicodincrutch.livejournal.com]

If you want an MRI, take a number.

You're laughing. What else?

[eternalnic.livejournal.com]

Can't stop....*giggles for a bit*...hard to breath.

[vicodincrutch.livejournal.com]

When was the last time you had beef?

[eternalnic.livejournal.com]

Prehaps a few days ago?

*pause and silence, apparently nic is turning off the mike when he giggles now*

I had a sandwhich.

*another silence*

with some roast beef.