Publications

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Hemichorea – A Rare Sequela of Striatal Infarction

JAMDA
March 1, 2020
Chorea is a hyperkinetic movement disorder that manifests as random involuntary movements with an irregular, flowing, and writhing quality. It is often described in the setting of hereditary neurodegenerative conditions; however, it may be secondary...

Fever, Myalgia, and Headache Progressing to Confusion: A Case of Neuroinvasive West Nile Virus in the Older Adult

JAMDA
March 1, 2020
West Nile Virus (WNV) infection is the most common mosquito-borne illness in the United States. Most cases are asymptomatic or with mild symptoms. Older adults are more likely to have central nervous system (CNS) involvement, and a higher risk for...

Early Identification of Acute Pulmonary Emboli Through the Use of Contact-Free Continuous Patient Monitoring

JAMDA
March 1, 2020
Skilled nursing facilities (SNFs) are faced with providing care for residents with increasing clinical complexity. Residents are being discharged from hospitals to post-acute care earlier and with multiple active co-morbidities. Clinicians working...

Discontinuation of Antipsychotic Medication in Two Nursing Home Patients with Diagnosis of Schizophrenia

JAMDA
March 1, 2020
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if...

Catatonia as an Usual Cause of Change of Mental Status in a Veteran in a Long-Term Care Facility

JAMDA
March 1, 2020
Catatonia – a diagnosis that involves motor, cognitive, behavioral, and autonomic irregularities -- may be seen in a variety of medical, psychiatric, and neurologic conditions or medication exposures. Here, we describe a case of catatonia seen in a...

Avoiding Sodium Polystyrene Sulfate (SPS) in Hyperkalemia

JAMDA
March 1, 2020
Hyperkalemia, defined as a concentration of potassium greater than 5.5 mEq/L in adults, is commonly found on labwork in the subacute nursing facility, often seen in the setting of kidney disease as a result of impaired excretion of potassium in the...

Atypical Progressive Meningioma: Not Always Benign

JAMDA
March 1, 2020
While relatively rare in the general population, meningiomas are the most common tumors in the CNS. Most meningiomas are benign (80%) and can be managed only with continued observation without need for surgery or radiation therapy. There is also a...

An Unusual Case of Fever and Altered Mental Status

JAMDA
March 1, 2020
Parkinsonism hyperpyrexia syndrome (PHS) is a dysautonomic disorder that was described in 1981 for the first time. It can present after reduction or discontinuation of antiparkinson medications, co-prescription of neuroleptic medications,...

A Recipe for Disaster: Gabapentin and Opioid Use in an Older Adult

JAMDA
March 1, 2020
Chronic pain is common among older adults, as is the use of medications to treat these symptoms. Aging physiology, in combination with a higher likelihood of medication use and declining renal function, makes older adults more susceptible to adverse...

A Case of Trunnionosis After Total Hip Arthroplasty

JAMDA
March 1, 2020
Trunnionosis is a complication after placement of prosthetic devices that composes 2% of revisions of total hip arthroplasty. Metal-on-metal hip replacements include the ball, the stem, and the prosthesis that rests on top of the ball. The trunnion...