December 8th, 2010

tree_white

Decreased CSF flow

Hi there,

I have a few questions for a story that may or may not see the light of the day. The story is set in a fandom that deals with paranormal and such so there's a pretty big leeway, but I still want to be accurate (or at least know what I'm writing about). It's also set in the present.


My MC is a man around thirty, suddenly suffering from bad headaches, dizzines, fatigue. Those symptoms start out of nowhere and are worse when he moves around. Laying down they go away after a while. Now the reason for him to experience these symptoms is some kind of a parasite (leech) that survives on CSF. It never takes enough to kill the host, but enough to make him feel bad. I have googled around looking for info on the subject and found a condition called Chiari... also that the symptoms are similar to the after effects of LP, when there's not enough CSF to 'support' the brain. Okay, hope it still makes sense lol. My questions:

1.What are the effects of repeatedly decreased CSF? Is it just the headache and other symptoms or is there a real threat of brain damage from a sudden movement (something like getting a concussion?)
2.Can a doctor do an LP and take a sample of CSF while it's decreased? Won't it make it all worse? Or will the doctor first measure the CSF pressure and stop the procedure upon finding it low?
3. I've read somewhere that after an LP when the sympotms are bad the patient can be injected with kofein or saline... does it go to an IV or right to the spine?
4.Final question... is any inflammation of the brain visible on MRI or CT scans?


Search terms used: decreased CSF, Chiari, Lumbar puncture, CSF. increased CSF, IIH, ICP. Both on Google and wikipedia.

PS: I know these are mighty strange questions:-) and I will be thankful for any replies really. While the google helped some, it brought on a ton of new questions which may not be importnant to the fic but are nagging at my mind.

Thanks in advance,

Cheers,

Nicol.

ETA: Big thanks for all the fantastic answers! You were all really helpful. Now I'm off to do some writing:-)
baby

medical explanation for psychic phenomena

I have a character who is receiving psychic messages through her dreams. The setting is real world, modern day, so she's unaware of what's happening or the fact that it's even possible. The character is female, about twenty-five, with no known physical or mental health issues.

Because the person sending these messages to her subconscious can't always predict her sleep schedule, and can tell when she's fully awake or asleep but not when she's making the transition, she occasionally receives one just as she's waking up. She's not aware that she's receiving anything, as the information bypasses her conscious mind, but she gets a feeling like a painless electric shock, and hears a sound like a radio makes if you touch its antenna, which is enough to wake her up fully and leaves her feeling startled.

After determining that this is not caused by too much caffeine (she stops drinking coffee) or radio waves being picked up by her fillings (she doesn't have any), she decides to go to a doctor to see if there's something wrong with her.

My question is, what might her doctor suspect was going on here? Is there anything physical that might cause this type of symptom? She's conscious of it no more than once a month, and has no way of predicting when it will occur, and I'm not sure if it would leave any evidence other than an elevated heartrate. Would the doctor need to monitor her while she was sleeping, or is there something else he could test for in a different way? It's okay if the tests are negative or inconclusive, because I need them to move on to psychological problems afterwards.

Speaking of which, what might a psychiatrist suspect?

I googled "sleep disorders", but I don't have enough medical knowledge to narrow it down any more than that.

Thanks!

ETA: I neglected to mention that my character, by the time she decides to trouble her doctor about this, is developing insomnia due to being entirely freaked out by her morning jolts, which makes her sleeping patterns less predictable and thus ups the frequency of the mistimed messages. So at that point it's happening on something like a weekly basis, as opposed to the first eleven spread out over a year.

Also, while I would certainly appreciate more input, I think her doctor is going to suggest exploding head syndrome. Because who wouldn't want to devote a chapter or two to that?

Thanks, everyone.
Waldsen questioning besties

Epilepsy

Hello, awesome detail oriented community!

I am looking for some advice and information on epilepsy for a role playing character of mine (I hope that's okay to do here, too). I want to get this as correct and realistic as possible.

Here's the situation.

My character is a 22 (just turned 22 less than a month ago) year old female. The year is 2010, December. And no alternate universe or anything. Just normal modern times. She has consumed quite a lot of alcohol since her early teens, a little less in the more recent years but she still drinks, and has done marijuana.

And, you guessed it, I want her to develop/discover that she has epilepsy.I have done some serious google-fuing and wikipediaing on this subject, but instead of giving me answers and making things more clear for me, it has left me even more confused and even more questions. So, I ask for help.

I understand that usually epilepsy develops between the ages of 5 and 20, but it can occur pretty much at any stage of life, correct?

I have looked into some of the more common syndromes, but I can't really decide which would be right for this character. So to speak. I think it could be either one of those 'no idea where it came from' epilepsy or inherited if it can come from grandparents. I don't want it to be too serious. I understand that epilepsy is serious no matter what, but I would like it to be something that can be controlled with medication and regular doctor visits and such. And, of course, something age appropriate. So suggestions in that department would be more than welcome.

I have also read that usually epilepsy is diagnosed after two seizures. Is that correct? Is there any way that it would be diagnosed and medicate after the first seizure? Like, maybe there can be some things in the person's history that one would just brush off as not being that important? Maybe like spasms, fainting, passing out stuff like that that?

Is there a certain way that the (first) seizure happens? Other than spasm and involuntary movement what else is very common?

I would also love to be pointed towards some epilepsy stories, especially for those who it was diagnosed in their young adulthood.

Thanks so much in advance!
Manga Nightingale

Metropolitan Police Murder Squads

I've found this site so useful and rarely had a chance to give anything back I thought I'd give my latest notes on the Met's current homicide procedures.

Referred to by police officers as Murder Squads or Murder Teams there are about 17 teams based at various police stations through out the MPS area - the details I have here relate to a team based at Belgravia nick (where 2 teams are based).

Each team is headed by a DCI
Under him/her are 3 DIs who split the individual cases between them as they come up.
Below them are 4-6 detective sergeants and below them, doing most of the work, are 20-25 DCs or PCs in plain clothes.
There are also civilian admin staff and data entry people.

A murder team is split into two uneven sections...
INSIDE INQUIRY TEAM consists of a senior DS (Case Manager) and a data entry team DCs, PCs and civillians) who are responsible for making sure all the information is inputed into the HOLMES 2 system - they are the only people who directly input data into HOLMES 2.

THE OUTSIDE INQUIRY TEAM consists of everyone else. In the first 36 hours of a job everyone will focus on that case as the leads start to dry up they return to the routine grind of wearing down their other cases. The Met's murder investigation policy is to run down every single fricking lead until either you catch the bastards responsible or run out of leads.

Most of the legwork is done by DCs who tool around London in unmarked cars usually bought second hand from other fleet providers. Murder squad cars don't carry lights, radios or sirens because it's not their job to rush about, the Met has people for that.

There's a briefing every morning so some things you see on TV are true.

The DCI, the DIs and the DSs sift through the information (using HOLMES) and assign ACTIONS which are given to DCs who go out and interview people, collect statements, evidence, track down family etc, this information is fed back to the Inside Inquiry Team who put it on HOLMES which generates more ACTIONS and so on and so forth.

It's sounds very bureaucratic but officers are expected to use their initiative, if an interview with one witness leads to another witness who's nearby the DC is expected to move on to that witness (he doesn't come back and wait to get another action). The big sin is not feeding this information back in a timely fashion and not letting your senior officer know what you're doing.

I hope that helps anyone doing murder related things in London - Present day.