She has no other past medical history; her past surgical history is significant only for an appendectomy at age 5 and an intrathecal baclofen pump last year for her spasticity. Her vital signs are normal; it is 8 pm in a busy ED, and the girl is bright, interactive, and attentive. Her physical exam is normal, with her baseline motor compromise; there is no evidence of trauma, infection, or toxidrome.
Regarding her management, which of the following is the single BEST answer:
A. Admit the patient for observation and caregiver holiday
B. Keep the patient in the ED in a relaxed, supine position for a brief observation
C. Send the patient home with a short PO course of baclofen to prevent evening
D. Discharge the patient with referral to psychiatry to evaluate coping skills
In the meantime, a quote –
Nothing is easier than self-deceit. For what each man wishes, that he also believes to be true.
– Demosthenes (384 BC - 322 BC)