60 year old female with schizoaffective disorder on clozapine and lithium + other meds who is pretty functional and relatively normal at baseline. Has a one week history of episodes of weakness, "spasms" and falls. Comes into the ED with AMS, dysarthria and weakness. Afebrile. 3-4/5 strength.
Head CT and MRI are negative. Labs negative, except elevated wbc (but chronic, over 2 decades of lymphocytosis). Chest x ray shows ground glass opacities b/l. Urine is normal.
Treated with antibiotics...
Difficult altered mental status/generalized weakness case - thoughts?
Head CT and MRI are negative. Labs negative, except elevated wbc (but chronic, over 2 decades of lymphocytosis). Chest x ray shows ground glass opacities b/l. Urine is normal.
Treated with antibiotics...
Difficult altered mental status/generalized weakness case - thoughts?