Also known as: Chiari malformation
The primary diagnosis - a congenital structural abnormality at the base of the skull that was asymptomatic until electroconvulsive therapy caused brain swelling, leading to CSF flow obstruction and triggering all of the patient's symptoms including syncope, aphasia, cardiac arrest, and neurological problems.
Also known as: Excess prolactin causing lactation
Secondary condition caused by the Chiari malformation - brain compression against the pituitary gland resulted in elevated prolactin levels, causing galactorrhea (lactation) and erectile dysfunction.
Also known as: Fluid around the lungs
One of the presenting symptoms with at least 200cc of fluid in the pleural space, initially investigated as a primary cause but ultimately a manifestation of the underlying Chiari malformation.
Also known as: Mono, kissing disease
Discovered during workup via lung tap cultures, initially considered as a possible explanation for the pleural effusion but ultimately an incidental finding that did not explain the full clinical picture.
Also known as: Heart stopped
Life-threatening complication that occurred during EEG testing, requiring defibrillation. Ultimately explained by the cerebral hypoperfusion and autonomic dysfunction caused by the Chiari malformation.
Also known as: Fainting
Recurring symptom - patient fainted at the altar during his wedding and had multiple subsequent episodes. Initially investigated as postural orthostatic tachycardia syndrome but ultimately caused by the Chiari malformation's orthostatic effects.
Also known as: Speech/language problems
Presenting symptom where the patient lost his ability to speak at his wedding, which resolved when he was lying down due to positional changes in cerebral perfusion related to the Chiari malformation.
Also known as: CSF leak
Iatrogenic complication from the spinal tap procedure that worsened the patient's headaches and temporarily mimicked symptoms, requiring a blood patch to seal the leak.