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Seizing the Moment

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Seizing the Moment is case #2 in House M.D. - Critical Cases.

An aspiring singer, Diana DeMauro, is admitted as a Jane Doe after suffering a seizure at the Spree Night Club.  She is accompanied by her manager Kathy.

The case is assigned to House's team, but because she was admitted as a Jane Doe to protect her reputation, the team has no medical history, and as her tox screen was negative, drugs are ruled out as a cause of the seizure.

After doing a blood analysis and spending $3 of the budget, the results show that the patient does not have elevated prolactin levels.  This rules out epilepsy.

The patient is given imaging and after spending another $3 of the budget, orthostatic hypotension is ruled out.

The manager tries to get "Jane" discharged, but Taub insists that hospital policy requires that she be kept at least 24 hours for observation.  As her test results show low glucose and irregular norepinephrine production, the patient is treated for meningitis for $3 of the budget.  

Jane regains consciousness, but doesn't recognize Kathy.  This leads House to realize Kathy's status as guardian can be challenged.  Jane soon has another seizure, starts laughing uncontrollably, and shows signs of cognitive decline.  She soon goes to code blue and has to be defibrillated.

The team does an environmental scan at the night club and finds the patient's purse.  It contains an insulin pump, showing that the diabetes mellitus was a pre-existing condition.  After using 3 chemical meds and spending $100 of the budget, they rule out diabetic ketoacidosis.

A further blood analysis shows that she is hyperglycemic.  After using one oxygen mask, they rule out hypoglycemia.

A further environmental scan finds a $100 bill at the night club.  Although it has cocaine on it, it does not have the patient's fingerprints on it.  After spending $200 of the budget, they rule out cocaine abuse.

The team believes "Jane" has Kanner's autism, a condition that requires an ongoing pharmaceutical regimen.  Kathy first accuses the doctors of trying to soak Jane for everything she has, but realizes that if the industry realizes Jane has an ongoing medical condition, she probably won't be able to find work.  She leaves the hospital.

The team treats the Kanner's autism with five gland pills.  However, Jane does not improve and starts suffering from hallucinations and tachycardia.  This rules out the diagnosis.  Jane suffers another code blue and has to be defibrillated.  

Eric Foreman starts taking the case personally and orders a number of procedures.  

Another environmental scan of the night club finds a pill bottle for lithium.  After treating the patient with 3 head meds, the doctors realize the hallucinations were a pre-existing condition.  As the lithium didn't help, this rules out bipolar disorder.

A further round of imaging and treatment with 3 heart mets rules out tonic seizure.

A further blood analysis, and an expenditure of $200 of the budgets, shows the patient has a clotting problem.  This rules out supraventricular tachycardia.  

Another blood analysis shows abnormal electrolyte levels.  Treatment with 3 body meds rules out hypercalcemia.

The team decides to treat the patient for the remaining differential, a rare condition known as GAD-ab autoimmunity.  This costs $200 of the budget, but the patient soon regains consciousness and is lucid.  

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