Dylan Miller

As featured on A popular Alaskan climber fell to his death from Yosemite National Park's El Capitan.

This photo courtesy of Dylan Miller shows Alaskan climber Balin Miller climbing the route "Croc’s Nose" at Crocodile Rock in Hyalite Canyon near Bozeman, Mont., Sept. 29, 2024. (Dylan Miller

Psychiatric comorbidities are highly prevalent in patients with epilepsy. This can complicate the management of seizures, as antiseizure medications (ASMs) can interact with psychotropic drugs or worsen psychiatric symptoms. We report the case of a 70-year-old woman with schizophrenia and bipolar disorder who presented with acute confusion and was found to have an elevated serum lithium level and an acute right temporal lobe intraparenchymal hemorrhage. Levetiracetam was initiated for seizure prophylaxis but was discontinued due to concern for psychiatric side effects. Oxcarbazepine was started and provided seizure protection with better psychiatric tolerability. This case illustrates the unique challenges of seizure prophylaxis in patients with psychiatric comorbidities.

Let’s get one thing straight: yes, Dubai has malls. Yes, there are rooftop lounges where people sip mocktails in designer clothes. But if you think that’s all there is, you’ve only seen the brochure version. Spend a little time here, especially with your own wheels, and you start noticing something...

Evaluating altered mental status (AMS) in patients with psychiatric illness presents a major diagnostic challenge, particularly when acute neurologic pathology such as intracerebral hemorrhage (ICH) is present. This report describes a 70-year-old woman with schizophrenia and bipolar disorder on haloperidol, lithium, and clonazepam who presented with confusion, rigidity, and agitation. Workup revealed a supratherapeutic lithium level and a right temporo-occipital intraparenchymal hemorrhage. The differential included lithium toxicity, catatonia, seizure, and hemorrhagic progression.Multidisciplinary evaluation with neurology, psychiatry, and neurosurgery, along with EEG and serial imaging, identified right temporal epileptiform activity and stable hemorrhage. Gradual improvement followed medication adjustments and antiepileptic therapy.This case underscores the diagnostic complexity of AMS in patients with coexisting psychiatric and neurologic disease. Overlapping symptoms can obscure acute intracerebral pathology, emphasizing the need for interdisciplinary collaboration, serial neuroimaging, and prompt EEG when indicated.

Buying a used car can be a smart move for your wallet. But to make sure you get a reliable vehicle at a fair price, you need to be prepared. Understanding a car’s true market value is a big part of this. This is often where the idea of the Blue...

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