After her graduation in 1979, she was hired by ABC News as a journalist. During her 10-year career as a journalist, Sanders won an Emmy award for her reporting of Hurricane Hugo. She was repeatedly drawn to stories that focused around mysteries and medicine. After about 10 years of reporting, Sanders decided to pursue a career within the medical field.
She was accepted into the post-baccalaureate pre-medical program at Columbia University. After completing her pre-medical requirements, she was accepted into Yale Medical School. She completed her residency at Yale and became her class’s chief resident.
Sanders became an attending internal medicine physician for the Yale-New Haven Hospital. As her new career progressed, she joined Yale’s Department of Internal Medicine while also teaching primary care at the school of medicine.
In 2002, a friend of hers working at The New York Times sparked a conversation about what doctors could provide in a literature perspective. After more discussion, Sanders started writing a column for The New York Times called Diagnosis. The column would highlight medical mysteries that she would encounter with her own patients and those of her colleagues. She described the cases as mysteries, revealing the diagnosis in the following week's column.[4]
The column was adapted for the 2004 TV series House M.D., for which Sanders served as a medical consultant for the show.
Her work also has resulted in a documentary series. A Netflix documentary series titled Diagnosis was released in August 2019. Produced by the New York Times, each episode follows Dr. Lisa Sanders as she seeks to diagnose patients with difficult symptoms.[5]
In addition to writing a column for The New York Times, Sanders has written 4 books related to medicine.
Cast
Lisa Sanders — physician, narrator, and columnist for The New York Times.
Angel Parker — a 23-year-old nursing student from Las Vegas, Nevada. Her symptoms include episodes of severe muscle painthat render her immobile.
Sadie Gonzalez — a 7-year-old girl from Queens, New York. She suffers from hundreds of seizures daily. Physicians initially suggest removing a large part of her brain (a hemispherectomy) as a form of treatment.
Willie Reyes — a 46-year-old Army veteran from Vado, New Mexico. He suffers from frequent seizures that result in memory loss and mood swings.
Kamiyah Morgan — a 6-year-old girl from Vermillion, South Dakota. She has frequent fainting episodes that can happen up to 300 times a day; these cause her to temporarily go limp and unresponsive.
Lashay Hamblin — a 16-year-old high school student from South Jordan, Utah. She cannot keep down any foods or liquids but does not have bulimia.
Matt Lee — a 20-year-old college student from Mt. Airy, Maryland. He suffers from frequent fainting spells that occur when he feels a sense of deja vu. These fainting spells also cause his heart to momentarily stop.
Joe — a 61-year-old man from Wallingford, Connecticut. He was struck with a sudden and unexplained paralysis from his waist down, leaving him paraplegic.
Ann — a 42-year-old patient from Wallingford, CT. She has intermittent paralysis affecting the right side of her body. She will regain mobility but the paralysis always occurs again.[6]
Episodes
No.
Title
Original release date
1
"Detective Work"
August16,2019(2019-08-16)
2
"Second Opinions"
August16,2019(2019-08-16)
3
"The Wisdom of the Crowd"
August16,2019(2019-08-16)
4
"Looking for a Village"
August16,2019(2019-08-16)
5
"A Question of Trust"
August16,2019(2019-08-16)
6
"Déjà Vu"
August16,2019(2019-08-16)
7
"Paralyzed"
August16,2019(2019-08-16)
Episode 1: Detective Work
Angel Parker is a 23-year-old nursing student. Her earliest memory of her illness dates to when she was 14, and woke in the middle of the night not able to move. Since then her illness has progressed into daily severe muscle pain episodes, where the pain will start at the bottom of her legs and grow its way up to jaw. These episodes render Angel immobile for hours, her pee is pitch black, and very frequently she has to be admitted to the hospital. Angel says that any increase in physical strain or exercise makes her symptoms worse but she still pursues athletic activities. Each time she is admitted, physicians have been unable to find a cause for her pain. She has been tested for Rheumatoid Arthritis, Lupus, Multiple Sclerosis, and Autoimmune diseases - all have had negative results. After a colleague sent Angel’s story to Dr. Lisa Sanders, she decided to take on the case and seek a solution. Dr. Sanders published Angel’s story in her column, Diagnosis, asking readers to help find a diagnosis for her symptoms. One big medical anomaly that physicians have recorded during Angel’s episodes is a rise in her Creatine Kinase levels. Creatine Kinase is muscle protein; Angel's highest CK level recorded during an episode was 57 thousand U/L in comparison to average levels of 22-198 U/L.
After Dr. Sanders published Angel’s story, she received thousands of responses on possible diagnosis based on the symptoms. The most common response was the possibility of a Metabolic Myopathy that translates to a metabolic muscle illness and are usually caused by the muscle's inability to breakdown nutrients. The muscles begin to break themselves down to yield energy. As Angel gets closer to possibly having a diagnosis, she starts to think about a possible future with children. She worries that if her disease is genetic, she wouldn't want to put her children at risk.
A medical student from Italy reaches out to Dr. Sanders. She describes her 4th- year thesis on metabolic gene testing that could be beneficial in narrowing down a diagnosis. Angel travels to Turin, Italy for blood and urine testing. The testing showed that Angel had a normal metabolic gene profile, which eliminated many possible metabolic disorders. The physicians in Italy submitted her genomes into a sequencing trial that could take up to two months to process but could hopefully result with a diagnosis. After the two months, Angel receives a call from the Physician with a complete result and a solid diagnosis of Carnitine Palmitoyltransferase II Deficiency.
Episode 2: Second Opinions
Sadie Gonzalez is a 7 year old little girl from Queens, NY, with a severe brain disorder. Sadie suffers from very frequent seizures that have resulted in a slight speech and mobility impediment. Her mother recounts the first time Sadie had a seizure being the morning of the 29th of December, when Sadie was 6 years old. The seizures stopped for two months and in late February Sadies seizures started to violently progress into daily visible seizures that will affect different parts of her body at a time. At the time of recording the episode, Sadie was having a motor seizure almost every couple of minutes. Sadie was admitted into the Columbia Presbyterian where multiple MRI’s were done showing no signs of brain damage or brain tumors. These results along with her symptoms led some physicians to believe she had Rasmussen’s. Rasmussen’s Encephalitis, explained by Dr. Lisa Sanders, is characterized by the chronic inflammation caused by T-Lymphwhite blood cells to invade half of the brain and destroy it. The only sure treatment for Rasmussen’s is a hemispherectomy, where the corpus callosum is severed and separated the diseased side of the brain from the healthy side. Direct consequences from this procedure is loss of vision in one eye, losing the ability to move one entire half of her body, one can also lose the ability to speak. If Sadie actually does have this disorder and does have the procedure then half of the brain can spread into the second half, causing the brain to deteriorate.
The parents of Sadie reach out to Dr. Lisa Sanders in hopes of getting a second opinion, a different diagnosis, or a different treatment. Essentially looking for any route that could lead to a better life for Sadie that doesn't have to hinder her more than her disease hinders her now. Dr. Lisa Sanders put their story out onto her column and awaited for the responses. Many of the responses from the audience agreed with the diagnosis of Rasmussen’s, others suggested that the seizures could be controlled with electro stimulation therapy, and a third group suggested it was a neurologic version of Lyme Disease. She was tested for various diseases under different conditions and one specific test came back strongly positive, resulting in a diagnosis that led to a manageable treatment, and also a responsive neurostimulation device was implanted by a neurosurgeon.
Episode 3: The Wisdom of the Crowd
Willie Reyes is a 46 year old Army Veteran who is slowly losing his memories as a result of frequent seizures. Willie’s wife recounts the first time he had a seizure when he was 44 and he just fell to the floor one day without any explanation. Since the first seizure, he has developed multiple brain lesions, progressive memory loss, hearing loss, and violent/emotional mood swings. Willie says that because of his memory loss he forgets a lot of things and constantly repeats himself, making him feel like a child. He tells his biggest fear being waking up one day and completely forgetting about his family. His daughter highlights the fact that recently he's been starting to forget major memories, from her childhood such as her birth. Dr. Lisa Sanders took a look at Willie’s MRI scans and noted a huge lesion at the base of his brain with finger-like deterioration rooting up from it. She has a theory that the deterioration reaching the memory region of his brain could be the reason for his memory loss and mood swings. His wife states that in June 2019, he had a biopsy done with a piece of brain matter and the results came back as having unspecified inflammation. Dr. Sanders says that one of the biggest reasons that his condition is hard to diagnose is because it has very similar symptoms to a lot of common brain disorders, with no response to steroids.
Dr. Lisa Sanders took out to publish Willie’s story and awaited the response with a possible diagnosis. Dr. Sanders expresses her disappointment in the fact that even if they are able to find a diagnosis or treatment for his illness, he may not be able to recover all the memories he has already lost. From the hundreds of responses Dr. Sanders highlighted 2 very interesting possibilities one caused by a virus and the other caused by an autoimmune disorder. The first possibility is Progressive Multifocal Leukoencephalopathy that is caused by a virus and destroys the brain's ability to translate information. The second possibility is a very rare autoimmune disease by the name of Neuro-Behcet’s that causes inflammation and ulceration in different types of the body. Neither of these diagnoses seemed to fit Willie exactly because of key features such as Willie’s very strong immune system and the fact that he had no response on steroids. Due to Willie’s background in the Army, the suggestion of the Gulf War Illness was brought up. When Dr. Sanders brought this idea to another physician for a second diagnosis, they highlighted key similarities of symptoms between Willie and the Gulf War Illness despite his being much more severe. The idea of the Gulf War Illness was tossed around as a possibility and brought up to many Physicians for second opinions, each one highlighting his symptoms are much more severe, and suggesting the possibility of testing for further clarity. To better understand the chances of Willie having GWI, they need to know if he was exposed to the toxins present during the Gulf War. However, the military provided him with no records of any medical discrepancies caused by actions during war. If Willie was to be diagnosed with Gulf War Illness he would not have a course of treatment, he would have to learn to cope with the disease until a treatment becomes available in the hopeful near future. Willie and his wife go to visit a Marine Veteran who was diagnosed with Gulf War Illness to be able to relate any similarities and narrow down the possibilities.
Episode 4: Looking for a Village
Kamiyah Morgan is a 6 year old little girl who suffers from a very unusual set of fainting episodes that will leave her unresponsive and immobile, and they can happen up to 300 times a day. When she experiences a fainting episode she will become completely paralyzed affecting everything in her body including her lungs, her mother states that every day that passes her ability to breathe diminishes. Kamiyah’s mother said that these fainting episodes started when she was about 8 months old as she would be crawling and suddenly tip over and go limp. At first their pediatric physician said the episodes looked like she was having a seizure, but after running an EEG there was no seizure being detected during the episodes. They then tried testing with MRI for any brain tumors or malignancies but again there was nothing. They were then referred over to the NIH or the National Institute of Health where their entire purpose is to be able to research and hopefully diagnose very strange cases. They NIH tested every system and every symptom and they were unable to find anything, they submitted her blood in for testing and they have yet to hear of anything from them for over two years. When Dr. Lisa Sanders asked the NIH for Kamiyah records; they were reluctant to release them even though she had her mother's permission, very shortly after this interaction Breteni, Kamiyah’s mother, received an email from NIH to discuss Kamiyah’s results. Breteni was upset over this interaction because it took them two years to be able to come out with her daughter’s results and only after an interaction with Dr. Lisa Sanders. Dr. Sanders believed this was because they might have initially forgotten to share the results and didn't want to ligate any misinterpretations. Once Breteni received the results it was shown that Kamiyah had a break in a gene that wasn't inherited from her mother or father, it created itself. Specifically a break within the KCNMA1 gene, and she was the first patient of her kind, she's “groundbreaking”. The NIH said that it would take more patients with the same illness and a doctor to “peg” it to be able to create a disease grouping for diagnosis.
When Dr. Lisa Sanders created the column for Kamiyah, instead of asking for the readers to chime in for their diagnosis, she went out looking for readers who would have the same symptoms/gene break as her. From the publication of the column, Breteni was able to find dozens of people who themselves or their children had the same KCNMA1 genemutation. There was also a scientist who reached out to Dr. Lisa Sanders, who had based the last 20 years of her career on researching the specific ion pathway for the KCNMA1 gene. The scientist goes into detail about the gene and how it regulates the amount of potassium that enters the cells and as a result this affects the brain wave levels corresponding to movement and in theory would create the fainting episodes. Kamiyah as well as all the patients found through the column became the breakthrough needed to begin proper human research towards a diagnosis and treatment of the gene mutation. While Kamiyah was not able to technically receive a diagnosis for her illness, she created the pathway for research into possible treatments for patients in the future.
Episode 5: A Question of Trust
Lashay Hamblin is a 16-year-old high school student at the time of filming the episode. She suffers from an illness with similarities to Bulimia, only she has no control over her actions. Everything that Lashay eats or drinks is almost immediately thrown up and she had very bad stomach cramping because of it. She expresses her bad experience with physicians who did not want to diagnose her because at only 16 years old she shows an almost exact reflection of an eating disorder. During her adolescence in 2014 her family went on a trip to Costa Rica where she had an encounter with a wild raccoon that tore at her skin. When she got back home from the trip only two days later she had severe symptoms of vomiting, headaches, neck pains and stomach pains. At first physicians thought it was rabies and immediately gave her the rabies vaccination, this however made everything extremely worse and all her symptoms progressed. Since that day in the emergency room she has yet to recover or improve from any of the symptoms. She's not able to walk straight up, sit in a chair, and has a constant throbbingheadache. Due to her conditions doctors decided to implant a chest port to be able to provide her with the nutrients and hydration she needs to survive. One physician the family met with suggested she might have a Cerebral Spinal Fluid Leak that would only explain her constant headaches and dizziness. The treatment for the CSF leak is an extremely invasive procedure that only has a 30% success rate, the family took the chance with the procedure and Lashay had an extremely rough recovery period. Since the treatment none of her symptoms had improved at all.
Matt Lee is a 20-year-old college student who suffers from fainting spells that only occur when he has a sense of Deja Vu, these fainting spells at times can cause his heart to stop all together. Matt states that when he was around 19, one day he just started feeling very light headed and had a sense of Deja Vu then shortly after he blacked out. When he woke back up and realized he had blacked out, he immediately went to the hospital, the next time he fainted had flatlined. Specifically his symptoms include a sense of tingling in his head that is followed by light-headedness, nausea, heart palpitations, loss of control, and then finally the Deja Vu before he faints. Matt is extremely afraid that these random fainting episodes could happen at any time during the day and he might not have someone to help him out, because of these he stays at home as much as he could. He expresses his disappointment in not being able to follow his goals in wanting to study computer science and wanting to find a cure or treatment that would allow him to be “free” again. Matt was admitted into Johns Hopkins Hospital for in depth testing of all his symptoms, the only definitive diagnosis known is the fact that Matt is experiencing Syncope. Syncope are essentially fainting spells that are caused by a decrease of blood reaching the brain, the only question is what is causing the decreased blood flow along with the other symptoms. Multiple testing was done to be able to narrow down whether his form of Syncope is caused by mental factors or cardiac abnormalities, the results are still pending.
Dr. Lisa Sanders took Matt’s story to the column and awaited for responses from the audience with ideas. Out of the hundreds of responses, only two were the most cohesive towards Matt’s symptoms. The first possibility was Vasovagal Syncope, where the nervous system will send an incorrect message too slow down the heart and can cause it to stop, the tilt table test performed on Matt could provide a definitive answer to this theory. The second possibility is Temporal lobe epilepsy which is a kind of seizure that is correlated to a sense of “strange” thoughts, feelings, or sense of Deja Vu. Matt was subjected to an EEG which did not show any preliminary seizure disorders, however the specialist who reviewed his results noted that the EEG might not express any deep temporal lobe seizures. The tilt table test performed on Matt came back negative for Vasovagal Syncope, however Matt was fitted with a heart tracker to be able to detect any abnormal signals within the heart during an episode. Matt finally had an episode with his heart loop tracker, the tracker was able to detect a 6 second heart stop during his episode. On the same day Matt had this episode he had another one once his stress level started to rise, this was the first time in the entire duration of his illness that he's had two episodes in one day. Dr. Lisa Sanders then questions if the episodes could be caused by an increase in stress, rooted by a traumatic stress episode within his early childhood involving custody actions between his mother and father. To help Matt out with the stress and psychological aspect of his illness, he was referred to a psychiatrist at Johns Hopkins that started him on cognitive behavioral therapy. While the cognitive therapy would help Matt out with his internal stress it might also help alleviate the severity of his episode until he is able to secure a valid diagnosis.
Episode 7: Paralyzed
Joe is a 61 year old optimistic patient from Wallingford, CT. He was struck with a sudden and unexplained paralysis starting from his waist down, leaving him paraplegic. Ann is a 42 year old skeptic patient who is also from Wallingford, CT. She has intermittent paralysis where she could spend hours with the right side of her body immobile. She will then regain mobility but the paralysis always occurs again. Around the age of 59, Joe started to get pin & needles in his legs and at first he thought nothing of it until a year later he had numbness up to his knees that progressed to his waist. Eventually, the numbness turned into paralysis and Joe became a paraplegic at the age of 61. Shortly after becoming paralyzed, Joe went into a state of organ failure that doctors were able to get him out of but ever since he hasn't been able to leave the hospital. Despite visiting many hospitals such as Yale, Mayo, and Boston with no avail, he states he is still a firm believer in western medicine and is willing to try anything. Around the age of 40, Ann had a recurring pain in her chest that resembled heartburn and a month later noticed that the right side of her face looked off. When she brought this up to her primary care physician, he explained that she had full right side facial paralysis and needed to visit the emergency room as she might be having a stroke. When she got to the emergency room, her facial paralysis was coming in and out, because of this she was placed into the stroke ward for observation and a CAT scan and MRI was ordered that resulted negative. A neurologist came in and told her it was all just a psychosomatic response to stress and nothing more. A big reason she does not trust doctors is for the fact that she is a woman of color, and she feels she's not heard by the generic privileged doctor complex. When reaching out to Dr. Lisa Sanders, both Joe and Ann had already been tested and ruled out for dozens of diseases such as Multiple Sclerosis, Parkinson's, and Lupus. Joe specifically has two very serious illnesses, the first one being his unexplained paralysis and the second being an incurable form of blood cancer he was diagnosed with 15 years back. Joe thought he only had a few years to live, but he was placed on a clinical trial that has kept him alive until this day. Dr. Lisa Sanders now wants to know if his blood cancer has anything to do with his paralysis, especially now that he has movement in his toes.
Dr. Lisa Sanders published both Joe and Ann’s stories on different columns to gain different traction from the audience and to not create confusion. The first column published was for Joe’s symptoms and this generated hundreds of responses. The two most reasonable possibilities are CIDP, Chronic Inflammatory Polyneuropathy, aka Guillain-Barre syndrome or the paralysis is a side effect of the clinical drug, Ibrutinib, he is taking to control his blood cancer. CIDP is a neurological disorder caused by an injury to the protective coating of the nerves as they leave the brain. However, this was almost immediately ruled out by his physicians as testing was already done against the possibility of CIDP. Leaving the paralysis to be a rare side effect of the clinical drug, Ibrutinib Joe was taking to control his blood cancer, only he hasn't been taking the medication since a blood clot almost killed him. Dr. Lisa Sanders suggests that his regaining feeling in his toes is a result of Joe being off the medication, as it could take up to a year for the medication to fully leave his body and for the nerves to rebuild themselves. This raises the issue that if Joe stays off the medication he might be able to walk again but if he doesn't get back on he will have nothing controlling his blood cancer. Dr. Lisa Sanders later published Ann’s story on the column and awaited the response from the audience. The audience presented with many possibilities but Ann’s doctors had tested and ruled them all out except for two. The first possibility is Lyme Disease which is an infection caused by bacteria transmitted through ticks. While Ann’s symptoms are not in line with that of Lyme Disease, the disease is known for causing all kinds of strange and interesting neurological problems. The second possibility is that Ann has a Functional Neurological Disorder, where simply her body is not transmitting the correct signals. Since Ann is very much a skeptic when it comes to western medicine she did not take the thought of a functional neurological disorder lightly, she immediately denied the possibility and moved on to get tested for Lyme disease. Ann went to a specialist near her and was able to get tested for Lyme Disease but the results came back negative. Even with this evidence in front of her Ann kept denying the possibility of having a Functional Neurological Disorder, yet she still received a call from Dr. Schneider who may be able to help her get closer to a diagnosis.[7]
Production
The Netflix docuseries Diagnosis was a production created and produced by Netflix and The New York Times together. It draws from the column written by Dr. Lisa Sanders, who seeks to help patients whose conditions have not been diagnosed and resist treatment.
For these episodes, Sanders seeks to crowdsource diagnoses and treatments. She published each case in her column, Diagnosis, in The New York Times and invited readers to help solve each medical mystery.[8] The emphasis is on the process of finding answers and patients are treated with respect. Doctors and patients from around the world have responded. Dr. Sanders has been able to provide each patient with a diagnosis of their case, sometimes leading to treatment, and also giving them a sense of belonging and hope.
Each patient’s journey through their diagnosis is shown in a 40-minute episode, where viewers can see the progression of a life-changing movement. The result from this project was a seven-episode docuseries. Diagnosis was released on August 16, 2019, on Netflix.[9]
Related Research Articles
Macropsia is a neurological condition affecting human visual perception, in which objects within an affected section of the visual field appear larger than normal, causing the person to feel smaller than they actually are. Macropsia, along with its opposite condition, micropsia, can be categorized under dysmetropsia. Macropsia is related to other conditions dealing with visual perception, such as aniseikonia and Alice in Wonderland Syndrome. Macropsia has a wide range of causes, from prescription and illicit drugs, to migraines and (rarely) complex partial epilepsy, and to different retinal conditions, such as epiretinal membrane. Physiologically, retinal macropsia results from the compression of cones in the eye. It is the compression of receptor distribution that results in greater stimulation and thus a larger perceived image of an object.
Conversion disorder (CD), or functional neurologic symptom disorder (FNsD), is a functional disorder that causes abnormal sensory experiences and movement problems during periods of high psychological stress. Individuals with CD present with highly distressing neurological symptoms such as numbness, blindness, paralysis, or convulsions, which are not consistent with a well-established organic cause and can be traced back to a psychological trigger.
Rasmussen syndrome or Rasmussen's encephalitis is a rare inflammatory neurological disease, characterized by frequent and severe seizures, loss of motor skills and speech, hemiparesis, encephalitis, and dementia. The illness affects a single cerebral hemisphere and generally occurs in children under the age of 15.
Non-epileptic seizures (NES), also known as pseudoseizures, non-epileptic attack disorder (NEAD), functional seizures, or dissociative seizures, are paroxysmal events that appear similar to an epileptic seizure, but do not involve abnormal, rhythmic discharges of neurons in the brain. Symptoms may include shaking, loss of consciousness, and loss of bladder control.
Heat syncope is fainting or dizziness as a result of overheating. It is a type of heat illness. The basic symptom of heat syncope is fainting, with or without mental confusion. Heat syncope is caused by peripheral vessel dilation, resulting in diminished blood flow to the brain and dehydration.
Viral encephalitis is inflammation of the brain parenchyma, called encephalitis, by a virus. The different forms of viral encephalitis are called viral encephalitides. It is the most common type of encephalitis and often occurs with viral meningitis. Encephalitic viruses first cause infection and replicate outside of the central nervous system (CNS), most reaching the CNS through the circulatory system and a minority from nerve endings toward the CNS. Once in the brain, the virus and the host's inflammatory response disrupt neural function, leading to illness and complications, many of which frequently are neurological in nature, such as impaired motor skills and altered behavior.
Primary polydipsia and psychogenic polydipsia are forms of polydipsia characterised by excessive fluid intake in the absence of physiological stimuli to drink. Psychogenic polydipsia caused by psychiatric disorders—oftentimes schizophrenia—is frequently accompanied by the sensation of dry mouth. Some conditions with polydipsia as a symptom are non-psychogenic. Primary polydipsia is a diagnosis of exclusion.
MELAS is one of the family of mitochondrial diseases, which also include MIDD, MERRF syndrome, and Leber's hereditary optic neuropathy. It was first characterized under this name in 1984. A feature of these diseases is that they are caused by defects in the mitochondrial genome which is inherited purely from the female parent. The most common MELAS mutation is mitochondrial mutation, mtDNA, referred to as m.3243A>G.
Phantosmia, also called an olfactory hallucination or a phantom odor, is smelling an odor that is not actually there. This is intrinsically suspicious as the formal evaluation and detection of relatively low levels of odour particles is itself a very tricky task in air epistemology. It can occur in one nostril or both. Unpleasant phantosmia, cacosmia, is more common and is often described as smelling something that is burned, foul, spoiled, or rotten. Experiencing occasional phantom smells is normal and usually goes away on its own in time. When hallucinations of this type do not seem to go away or when they keep coming back, it can be very upsetting and can disrupt an individual's quality of life.
Adams–Stokes syndrome, Stokes–Adams syndrome, Gerbec–Morgagni–Adams–Stokes syndrome or GMAS syndrome is a periodic fainting spell in which there is intermittent complete heart block or other high-grade arrhythmia that results in loss of spontaneous circulation and inadequate blood flow to the brain. Subsequently, named after two Irish physicians, Robert Adams (1791–1875) and William Stokes (1804–1877), the first description of the syndrome is believed to have been published in 1717 by the Carniolan physician of Slovene descent Marko Gerbec. It is characterized by an abrupt decrease in cardiac output and loss of consciousness due to a transient arrhythmia; for example, bradycardia due to complete heart block.
Medical model is the term coined by psychiatrist R. D. Laing in his The Politics of the Family and Other Essays (1971), for the "set of procedures in which all doctors are trained". It includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and prognosis with and without treatment.
Fazio–Londe disease (FLD), also called progressive bulbar palsy of childhood, is a very rare inherited motor neuron disease of children and young adults and is characterized by progressive paralysis of muscles innervated by cranial nerves. FLD, along with Brown–Vialetto–Van Laere syndrome (BVVL), are the two forms of infantile progressive bulbar palsy, a type of progressive bulbar palsy in children.
Foix–Chavany–Marie syndrome (FCMS), also known as bilateral opercular syndrome, is a neuropathological disorder characterized by paralysis of the facial, tongue, pharynx, and masticatory muscles of the mouth that aid in chewing. The disorder is primarily caused by thrombotic and embolic strokes, which cause a deficiency of oxygen in the brain. As a result, bilateral lesions may form in the junctions between the frontal lobe and temporal lobe, the parietal lobe and cortical lobe, or the subcortical region of the brain. FCMS may also arise from defects existing at birth that may be inherited or nonhereditary. Symptoms of FCMS can be present in a person of any age and it is diagnosed using automatic-voluntary dissociation assessment, psycholinguistic testing, neuropsychological testing, and brain scanning. Treatment for FCMS depends on the onset, as well as on the severity of symptoms, and it involves a multidisciplinary approach.
Medical diagnosis is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information required for a diagnosis is typically collected from a history and physical examination of the person seeking medical care. Often, one or more diagnostic procedures, such as medical tests, are also done during the process. Sometimes the posthumous diagnosis is considered a kind of medical diagnosis.
Panayiotopoulos syndrome is a common idiopathic childhood-related seizure disorder that occurs exclusively in otherwise normal children and manifests mainly with autonomic epileptic seizures and autonomic status epilepticus. An expert consensus has defined Panayiotopoulos syndrome as "a benign age-related focal seizure disorder occurring in early and mid-childhood. It is characterized by seizures, often prolonged, with predominantly autonomic symptoms, and by an EEG [electroencephalogram] that shows shifting and/or multiple foci, often with occipital predominance."
"Locked In" is the nineteenth episode of the fifth season of House. It aired on Fox on March 30, 2009. Large portions of the episode are shown from the perspective of the patient, who retains consciousness but lacks the ability to move. After discovering the patient in an emergency room while being treated for injuries related to a motorbike crash, House's team move the patient to Princeton Plainsboro and attempts to diagnose him. During the course of treatment, the team discovers several medically relevant secrets about the patient. Other plot points focus on Wilson's attempts to discover why House was in Middletown, New York when he crashed, Wilson's new relationship, and the resolution of Taub's resignation from the previous episode.
Lisa Sanders is an American physician, medical author and journalist, and associate professor of internal medicine and education at Yale School of Medicine. In 2002, she began writing a column for The New York Times called Diagnosis, that covered medical mystery cases. She is an attending physician at Yale-New Haven Hospital. Her column was the inspiration for the television series House M.D., with Yale-New Haven Hospital serving as the model for Princeton-Plainsboro Hospital in the series. Sanders worked as a consultant on the show. In 2019, Netflix aired the program Diagnosis, featuring a selection of cases from her column.
Vertiginous epilepsy is infrequently the first symptom of a seizure, characterized by a feeling of vertigo. When it occurs, there is a sensation of rotation or movement that lasts for a few seconds before full seizure activity. While the specific causes of this disease are speculative there are several methods for diagnosis, the most important being the patient's recall of episodes. Most times, those diagnosed with vertiginous seizures are left to self-manage their symptoms or are able to use anti-epileptic medication to dampen the severity of their symptoms.
Alternating hemiplegia is a form of hemiplegia that has an ipsilateral cranial nerve palsies and contralateral hemiplegia or hemiparesis of extremities of the body. The disorder is characterized by recurrent episodes of paralysis on one side of the body. There are multiple forms of alternating hemiplegia, Weber's syndrome, middle alternating hemiplegia, and inferior alternating hemiplegia. This type of syndrome can result from a unilateral lesion in the brainstem affecting both upper motor neurons and lower motor neurons. The muscles that would receive signals from these damaged upper motor neurons result in spastic paralysis. With a lesion in the brainstem, this affects the majority of limb and trunk muscles on the contralateral side due to the upper motor neurons decussation after the brainstem. The cranial nerves and cranial nerve nuclei are also located in the brainstem making them susceptible to damage from a brainstem lesion. Cranial nerves III (Oculomotor), VI (Abducens), and XII (Hypoglossal) are most often associated with this syndrome given their close proximity with the pyramidal tract, the location which upper motor neurons are in on their way to the spinal cord. Damages to these structures produce the ipsilateral presentation of paralysis or palsy due to the lack of cranial nerve decussation before innervating their target muscles. The paralysis may be brief or it may last for several days, many times the episodes will resolve after sleep. Some common symptoms of alternating hemiplegia are mental impairment, gait and balance difficulties, excessive sweating and changes in body temperature.
Functional neurologic disorder or functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement problems, sensory symptoms, and convulsions. As a functional disorder, there is, by definition, no known disease process affecting the structure of the body, yet the person experiences symptoms relating to their body function. Symptoms of functional neurological disorders are clinically recognisable, but are not categorically associated with a definable organic disease.
This page is based on this Wikipedia article Text is available under the CC BY-SA 4.0 license; additional terms may apply. Images, videos and audio are available under their respective licenses.
