Nandi Jawaharlal
Acute altered mental status, paranoia, and erratic behavior in traffic
Patient is a female in her 20s brought to the ED by her roommate, Charis, after wandering into a busy intersection, running in and out of traffic, and yelling at cars and pedestrians. The roommate reports a one-month history of progressive behavioral changes, including severe insomnia, talking to herself at all hours, and possible suicidality. Nandi has no known psychiatric history or recreational drug use. After initial sedation, the patient reported significant physical symptoms accompanying her psychiatric changes: severe bilateral hand tremors (inability to apply makeup), numbness in her feet (peripheral neuropathy), and episodes of depersonalization/derealization.
ToxicologyNeurology +2 more
