Halfway to the weekend

It was a rather busy Wednesday.

It started over in the National Hospital for Neurology and Neurosurgery (NHNN) at the Epilepsy Outpatient Clinic. Unfortunately, the Professor I was assigned to was not in, but I was able to join his Clinical Assistant. I sat in on the appointments, the majority of which were telephone calls. The assistant followed up with the patients to see how they were getting on if they had been having seizures, and if yes, made the required adjustments to their anti-epileptic medications. 

A day at clinic would not be complete without a selfie.

At noon, I attended the Journal Club. It is a weekly session where a doctor presents the findings of a recent journal article to other doctors. This week's article was titled, 'Association Between Ionised Calcium Level and Neurological Outcome in Endovascularly Treated Patients with Spontaneous Subarachnoid Haemorrhage: A Retrospective Cohort Study.'  I won't bore you with the details of the study, if you're interested and would like to have a read, the article can be found here.

In the afternoon, I attended the Queen Square Brain Bank Clinicopathological Conference. Doctors presented the clinical details of two cases with neurodegenerative diseases and correlation with post-mortem pathological findings. They went into detail about every visit the patient had to the clinic. They shared the results of all the blood tests, examinations, imaging, and treatment the patient received. In the end, the Pathologist spoke about the autopsy findings, the consistency with the previously given diagnosis, and the additional diagnoses obtained. 

It was interesting to look back at the complete history of a patient from their initial presentation until their death. This was a learning opportunity for us all. With this approach, we could trace back every step that was taken, follow every examination that was performed, and make conclusions about a diagnosis with the complete picture in front of us. Something the physicians treating the patient wouldn't have had at the time. 

While I learnt a lot today, two takeaways for me are:

• Sudden unexpected death in epilepsy (SUDEP) is the sudden unexpected death of someone with epilepsy, who was otherwise healthy, and where no other cause of death can be determined. 
• The benefits of medical case reports. The detailed information shared in the Queen Square Brain Bank Clinicopathological Conference presentation, while not officially published, provides insight into real-life situations that are essential for physicians, and may ultimately improve patient care. Each case adds valuable new information to our medical knowledge.