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The patient is in a s/l *total shell* with a headrest secondary to West Nile virus, some neuromotor dysfunction, but no acute changes.
This is mentioned in the HEENT exam on a discharge, not the reason the pt was admitted so have nothing else to go by and no other notes mention anything. He is just mumbling his way through this whole thing (new PA) and I cannot quite get what he is meaning, the "t" sound and "shell" are the only clear sounding parts, and googling with West Nile virus and headrest and/or treatment is coming up with nada. Any help appreciated! ty :)