Level 1: Mood Change – Contrasting Case #2: Patient Information

Given these changes from the original case, what is your diagnosis?

What is your diagnostic explanation?

As compared to the long case, this patient is an 83-year-old woman who presents to the ED by ambulance after her daughter witnessed her having a seizure and called 911. The patient is stabilized but remains confused, her daughter is the main historian. The daughter states that her mother has seemed somewhat depressed for the last 6 months. She has never suffered from depression before and has never had a seizure. She no longer does things she used to enjoy, and also has had a short temper with her children. 1 month ago she began having headaches, mostly in the mornings, which she said sometimes felt better after vomiting.

HEENT: +headaches, blurred vision.
GI: + N/V.

PE –
HEENT: Ophthalmoscopic exam shows papilledema.

Labs: Brain imaging shows tumor involving the frontal lobe.