Neuropathology 101 (Jaz/t'Tamarak)

[Jaiysa t'Tamarak 0]

PADD in hand, Eva exited the surgical bay where the former Chief of Security lay unconscious. The diagnostic was simple enough; finding the cause was, as her mother often said, a whole other ball game. She gave the PADD to Jaiysa who was out of the bay as well. There was no need for 4 physicians to close a nasty head wound. The doctors' time would be better spent examining the new Bolian patients and quickly finding the cause of this illness.

 

"These are Commander Precip's last scans, and since he's been spending quite a bit of time in here, they're pretty recent. I would say the oldest brain lesions don't appear to be more than 2 weeks old. There is nothing to indicate that this is a degenerative condition having reached its debilitating phase. Its seems like a sudden onset of..." Eva paused, thinking. "...of...something... affecting the motor neurons. It's just too sudden; the rapidity of the symptoms evolving into a complete neural shutdown as we see here seems to indicate something...an acute neuropathy... Guillain-Barré syndrome or similar but the scans results don't directly conform to that particular condition. There are too many inconsistencies that cannot be strictly attributed to xenoneurological differences.”

 

Jaiysa grunted agreement as she took the PADD, comparing it to the biobed readouts from the neural workup they had just completed. "It’s certainly na a degenerative disorder; his records would have shown evidence of such a condition before now. My conversations with the erei'riov have na suggested anything in the way of a progressing neurological incapacitation -- indeed the injuries for which we've seen him have, I believe, been entirely musculoskeletal. This...is entirely different."

 

Eva approached one of the life support units, picking up the chart started by Doctor Raleigh, and Jaiysa followed her, scrolling quickly through the readouts from Precip's bed with narrowed eyes. Her usual mildly dismissive sardonic air was gone, replaced by an expression of great focus. She was in her element. "I agree that it does na directly conform to the syndromes which would have been my first guesses as correlating with his expressed symptoms, but based on the pattern of neural damage, I believe we can state categorically that we are indeed dealing with a form of motor neurone disease -- probably focused in the corticobulbar pathways, as you said earlier..." She nodded curtly at Eva sideways in acknowledgement. "It is, however, manifesting in a form in which I have never seen it, in Bolians or otherwise -- usually the onset of such a condition occurs over a period of years, but the presentation of physiopathological symptoms in this case has, as I understand it, taken place within a matter of hours and progressed to the level of complete autonomic shutdown."

 

Eva nodded while approaching Lt Parrin’s bed side. “Neurocortical monitor‘s encephalographic data shows that the lieutenant here is having his neurological functions affected in the exact same pattern as Commander Precip. I suspect these two will show similar degeneration.” She said while looking over the two other immobile Bolian patients. The Trill doctor placed her fingers on each side of the cartilagenous ridge above Parrin’s nose to verify that his pulse was still as strong as indicated by the monitor, before approaching Lt Commander Tuk to confirm her assumption that he was also affected by the same rapid onset neurological degeneration.

 

Jaiysa didn’t even bother to glance at their readings; she just nodded. “Consistency in their symptomatology is of course something of a blessing in disguise; it means that there is a definitive external trigger. What that trigger might be, of course, is a fvadt mystery...” She snorted softly, drumming her knuckles lightly on the edge of the biobed. “For now...first-response should be our primary focus -- neurogenic stimulators should help to realign the synaptic firing pattern or at the very least provide some kind of secondary support system to the affected cellular material. 5 ccs of a cortical analeptic -- na more, or we could potentially send them into neural shock which would provide us with an entirely new set of problems. Life support should combat the critical aspects of the collapse of their visceral functions; I’d recommend either cortolin or leporazine for the purpose of attempting resuscitation but that’s useless to us if we can na determine what is causing the root failures...”

 

The Rihan maenek settled herself onto one of the seats near the biobed at which Eva stood, and steepled her fingers thoughtfully. “So what causes an immediate-onset degeneration of neural tissue in multiple independent patients without an immediately obvious external cause? Irumodic Syndrome?”

 

Eva shook her head indicating a negative. “Doesn’t fit...we would have had some report of the four of them exhibiting some kinds of delusions, and I’m not sure about the others but Cmdr Precip’s genetic mapping does not exhibit any of the chromosome mutations that could lead to Irumodic.” Taking a seat facing Jayisa, Eva tried, “Central pontine myelinolysis?”

 

“Doubtful,” Jaiysa answered crisply. “Their bloodstreams show na sign of recent correction for hyponatremia and none of them have a history of alcoholism or liver disease -- at least none present in their records. Besides, the neural damage is not limited to the pons region of the brain.”

 

Eva took a sip of coffee. “You’re right, it doesn’t fit...” She closed her eyes, calling up forgotten memories. “Heredopathia atactica polyneuritiformis? “

 

“If the degeneration was solely affecting the myelin sheaths, perhaps, which also rules out a number of leukodystrophies. Dysautonomia would explain the visceral failures...”

 

Eva shook her head again. "It would, but there had been no prior sign of excessive fatigue, polydipsia or orthostatic hypotention--”

 

“--that we know of--”

 

“--plus dysautonomia would not present itself in this way -- it would have been caused by an underlying condition unrelated to species-specific physiology or neurology. It seems pretty farfetched to think that the only four Bolians onboard suffered from the same genetic predisposition.’

 

Eva put her coffee down “We could go on for an hour...there is just no known neurological disease or illness that would present itself this quickly with those specific symptoms. It has to be environmental somehow...”

 

“Environmental...ie. And an entire new array of potential triggers unfolds itself in the blink of an eye,” Jaiysa answered, her tone turning a little irritable. Turning away from Eva, she eyed her console for a moment in thought and then threw up her hands in a gesture of frustration, letting them fall heavily on the console top with a thunk. “Well, fvadt!”