Case 1 M.G. is an 8-year-old boy who has been brought to the emergency department by his parents with a fever of 104° F, lethargy, headache, and stiff neck. Laboratory analysis of a spinal tap demonstrates increased white blood cells in the cerebrospinal fluid (CSF). Discussion Questions 1. What is the most likely cause of M.G.’s signs and symptoms? What is the origin and pathogenesis? What other laboratory findings would be consistent with this etiology? 2. What are common complications of this disorder, and how would one assess their occurrence? 3. What is the usual treatment for this disorder? Case 2

Case 3

Parkinson’s disease causes an imbalance of neurotransmitters, which interferes with brain functioning. According to the history, F.P. was diagnosed with this condition five years ago, and he might experience some motor difficulties such as imbalance, tremors, and bradykinesia, which is typical for this disease.

Dopamine is lower in the brain in patients with Parkinson’s disease, and they may experience difficulties transmitting signals that coordinate body movements (Bloem et al., 2021). Levodopa is a dopamine precursor used to treat this condition by causing an interaction with the decarboxylase enzyme to form dopamine.

While in the hospital, the patient could have experienced difficulty speaking with others, depression, and sleep disturbance since he has a history of Parkinsonism and seizures. Due to an enlarged prostate gland, he could also have experienced frequent urination because of a weak urinary system.

If F.P. has seizure episodes, his breathing rate, level of consciousness, and jerking movement of the upper and lower limbs should be assessed. Anti-seizure medications such as valproic acid and phenytoin may be administered.

Case 4

Some manifestations of dementia are confusion, restlessness, memory loss, lack of coordination, and sleep disturbances. Treatable factors that could have led to the deteriorating mental function of S.Y. are disorders of metabolism such as vitamin B12 deficiency, brain tumors, subdural hematomas, elevated intracranial pressure, hypoglycemia, hypothyroidism, neuro-cognitive disorders that are associated with HIV.

Organic brain alterations typical for Alzheimer’s disease are Cerebral amyloid angiopathy, amyloid plaques, neuronal loss, cell death, and chronic inflammation (Chong et al., 2021). Pharmacological management of dementia involves the use of drugs, which are cholinesterase inhibitors such as Rivastigmine, Galantamine, and Donepezil. Ways of preventing exacerbations of behavior by dementia patients are encouraging them to have enough sleep, ensuring the comfort of their environment, reassuring the patient if she appears distracted, and planning exercise or any physical activities for the day.