A Case Study on the Nervous System 2

Part II—The Doctor Visit





“So, what seems to be the problem, Mrs. Jackson?” Dr. Warner asked
Phyllis.

“My husband wanted me to come in and see you after I fainted during
my soccer game Saturday. I’ve also been having some problems at work,
but I think I’m just stressed.”

“What kinds of problems have you been having at work?”

“It’s been hard to concentrate on tasks. I’ve also had some problems
typing—I’ve been making more errors than usual, and oftentimes my
fingers will go numb.”

“I see,” said Dr. Warner, taking a few notes on his clipboard.
“According to my records you are not on any long term medication. Have
you noticed any problems outside of work?”

“Well, my husband has been complaining about our personal life
lately. And last week, I completely forgot that I was supposed to pick
up our two daughters after school. I’ve been feeling really tired
lately; even my coordination seems off.”

“How long has this been going on for?”

“A few weeks, but this isn’t the first time. These problems seem to
come and go, but it’s getting to the point where I can’t just ignore
them anymore. I don’t know, maybe I’m just depressed.”

“Why do you say that?”

“My mother suffered from depression throughout my childhood.”

“Well, depression certainly could cause some of the symptoms you’re
experiencing,” Dr. Warner said thoughtfully. “Is there a history in
your family of any neurological disorders?”

“I don’t think so. I have some vague recollection of my grandfather
in a wheelchair when I was really young, but I don’t know what was wrong
with him.”

“Okay,” said the doctor, nodding. “Well, the few preliminary tests
we’ve run show that you are not pregnant, and that you are not going
through menopause. I’d like to send you to see Dr. Thrush, a friend and
colleague of mine. She is a neurologist at the local hospital and she
will run a few tests to explore your symptoms a little further.”

Questions

1. What new signs or symptoms have been revealed?
   
2. Could any of Phyllis’s symptoms be attributed to
   depression? If so, which?
   
3. What neurotransmitters are thought to be involved in
   depression?
   
4. What neurological disorders could have put her
   grandfather in a wheelchair?
   
5. Could any of these neurological disorders explain one or
   more of Phyllis’ symptoms?
   
6. Could Phyllis have inherited any of these disorders?
   
7. If you were in Dr. Warner’s position, what tests might
   you suggest to confirm (or not) this diagnosis?