Introduction This case reviews a patient who presented to the emergency department (ED) with homonymous hemianopsia, a rare manifestation of partial status epilepticus of the occipital lobe.  Her initial brain computerized axial tomographic (CT) perfusion scan and magnetic resonance imaging (MRI) revealed novel findings associated with this diagnosis. Case Report A 70-year-old female presented to our ED with left visual field hemianopsia, dyskinesia, dysmetria and facial droop . Her initial diagnosis was left posterior fossa circulation cerebrovascular accident.  However, her neuroimaging indicated hypervascularity of the left occipital lobe without evidence of infarct or structural lesion. A cerebral angiogram excluded arterio-venous malformation.  Subsequently, an electroencephalogram showed left occipital lobe status epilepticus.   Conclusion Hemianopsia is a rare presentation of partial status epilepticus mimicking stroke.  Hypervascularity seen on advanced neuroimaging may have suggested this diagnosis on initial ED evaluation.

Introduction: To evaluate the impact of a simple emergency department (ED)–based educational intervention designed to assist ED providers in detecting occult suicidal behavior in patients who present with complaints that are not related to behavioral health.Methods: Staff from 5 ED sites participated in the study. Four ED staff members were exposed to a poster and clinical guide for the recognition and management of suicidal patients. Staff members in 1 ED were not exposed to training material and served as a comparator group.Results: At baseline, only 36% of providers reported that they had sufficient training in how to assess level of suicide risk in patients. Greater than two thirds of providers agreed that additional training would be helpful in assessing the level of patient suicide risk. More than half of respondents who were exposed to the intervention (51.6%) endorsed increased knowledge of suicide risk during the study period, while 41% indicated that the intervention resulted in improved skills in managing suicidal patients.Conclusion: This brief, free intervention appeared to have a beneficial impact on providers’ perceptions of how well suicidality was recognized and managed in the ED. [West J Emerg Med.2012;13(1):41–50.]