Digital Commons Network^™

Correlation Between Gross Pulmonary Pathology And End-Stage Chronic Obstructive Pulmonary Disease, Chloe A. Davis, Blessing A. Adeyemo, Paul M. Catalano, Reginald D. Dixon, Michael G. Elkos, Rachel E. Lippencott, George M. Zakour, Rasheed Agboola, Shiv Dhiman

Research Day

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation, chronic airway inflammation, and structural destruction of lung parenchyma. Long-term exposure to inhaled irritants, particularly tobacco smoke and environmental pollutants, contributes to chronic inflammation and remodeling of pulmonary tissue. In advanced stages of COPD, pathological changes such as alveolar destruction, hyperinflation, and particulate matter deposition may be present. While imaging and histopathological studies commonly describe these changes, direct anatomical observation during dissection provides a unique opportunity to correlate disease processes with gross pulmonary morphology.

Objective: To examine and document gross pulmonary abnormalities associated with …

Abdominal Aortic Aneurysm As A Marker Of Systemic Atherosclerosis In A Patient With Prior Coronary Bypass And Fatal Middle Cerebral Artery Stroke: A Cadaveric Case Study, Jordan B. Ahlgren, Azmeer Imran, Rachel K. Ransom, Akosua A. Crumbsy, Lindsey D. Cohen, Angela V. Covington, Mphatso J. Onyekachi, Shiv Dhiman

Research Day

INTRODUCTION: Abdominal aortic aneurysm (AAA) is frequently associated with systemic atherosclerotic disease and increased risk for cardiovascular morbidity. The development of AAA is attributed to hypertension, smoking tobacco, and other factors such as genetics. Patients with vascular diseases also develop multisystem involvement, including coronary, cerebrovascular, and cardiac conduction abnormalities. The purpose of this case study was to investigate the role artherosclerotic disease played the in the fatal left middle cerebral artery (MCA) ischemic stroke of a 75-year-old male with a visible abdominal aortic aneurysm, history of coronary artery bypass grafting (CABG), and permanent pacemaker implantation.

METHODS: Systematic gross anatomical dissection …

Studying A Case Of Dementia Associated With Thoracic Kyphoscoliosis And Potential Implications On Csf Clearance, Morgan L. Brown, Sara G. Roman, Collins D. Nelson, Anna Beth Boyette, Rasheed Agboola, Joshua Owolabi, Kristie Petree

Research Day

Purpose: This work presents a case of clinically established dementia associated with thoracic kyphoscoliosis in an effort to study the relationships between these presentations and cerebrospinal fluid clearance. Given the previously identified relationship between impaired CSF clearance and the development of Alzheimer’s disease, this case study aims to further explore the relationship, using a combination of gross pathological observations and histopathological methods to examine specific brain regions, including the choroid plexus. The observed kyphoscoliosis and its effects on CSF clearance, thereby contributing to the pathogenesis of dementia, are also considered.

Methods: Samples were collected from an 81-year-old male cadaver with …

Imperforate Hymen With Bicornate Uterus In An Adolescent Patient, Cheau Williams, Daniel Santiago, Catherine Cravey, Danielle Rosenzweig, Ebony Isagba, Mykala Jackson, Sabirah Smith, Alexandria Neal

Research Day

A thirteen-year old patient presenting with chronic pain and amenorrhea was evaluated for ongoing discomfort and worsening symptoms. Pelvic examination showed a vaginal protrusion consistent with imperforate hymen and imaging was consistent with significant hematocolpos. Hymenectomy was performed and a bicornuate uterus was revealed in postoperative imaging.

This case report adds to the medical literature exploring the diagnosis of imperforate hymens which occur in 0.1% of female neonates and may co-occur with a bicornuate uterus (0.4% prevalence in females). It provides a perspective on the rarity of the incidence of imperforate hymen patients with another genitourinary anomaly. It also challenges …

Unique Combination Of Scapula Fracture And Pectoralis Major Tear Sustained During Static Line Airborne Operations: Case Report, Kimberton Porter, Mykala Jackson, Kenneth Nelson, Jeffrey Hoffmann

Research Day

Scapular fractures are rare and often managed in a non-operative fashion. This report includes a case of a 35 year old active duty male who sustained a critically comminuted scapular body fracture with an isolated pectoralis major tendon tear whilst participating in a static line parachute jump. The patient presented with new onset left shoulder pain, inflammation, and functional loss but did not show any signs of associated systemic trauma. On imaging, there were scapular fragments that were displaced as well as a proximal pectoralis major rupture. Given the severe degree of displacement and the occupational demands of the patient, …

Postpartum Vulvar Hematoma: A Common Obstetric Complication, Ruhdeep Randhawa, Allison Tresner, Christine Lurie

Research Day

Introduction:

Vulvar hematoma is a collection of blood in the soft tissue called the vulva. Branches of the pudendal artery supply the smooth muscle and loose connective tissue. Vulvar hematomas are a common obstetric complication, but they can occur in non-obstetric settings as well due to trauma. During the birthing process, direct injuries, such as episiotomy, vaginal laceration repairs, or instrumental deliveries, and indirect injuries, such as extensive stretching of the birth canal during vaginal delivery, can lead to vulvar hematoma formation. Risk factors for vulvar hematoma formation include episiotomy, prolonged second stage of labor, macrosomia, anticoagulants, hypertensive disorders of …

Gross And Microscopic Case Study On Splenic Capsular Pathology In A Cadaver With Congestive Heart Failure: A Postmortem Evaluation, Sarah Kate Boyette, Clara James, Timothy Kim, Barrington Francis, Nathan Nguyen, Daylen Tirogene, Eguohoghene Ughwanogho, Shiv Dhiman, Cecil Cone

Research Day

Splenic pathology in the setting of systemic congestion is often characterized by parenchymal enlargement and vascular engorgement. In addition to these diffuse hemodynamic changes, discrete splenic lesions may be encountered, raising important diagnostic considerations. Such lesions range in clinical significance from incidental, benign nodules to processes that are infectious or malignant in nature. However, isolated capsular parenchymal abnormalities are less commonly described. We report a cadaveric case of a donor with documented cardiac failure and multiorgan enlargement, including cardiomegaly, hepatomegaly, and renomegaly. Gross examination of the spleen revealed discrete nodular irregularities confined to the capsular surface without extending into the …

Gross Anatomical Manifestations Of Metastatic Sigmoid Colon Adenocarcinoma Observed During Cadaveric Dissection, Rachel M. Fontaine, Sabrina Mack, Diana Petrucello

Research Day

Introduction:

Adenocarcinomas are malignant tumors that originate from mucus-secreting glandular cells within the epithelial layer of the mucosa. The sigmoid colon is a frequent primary site for these tumors, which commonly arise from precancerous adenomatous polyps that gradually become malignant through progressive dysplastic changes. Adenocarcinomas of the sigmoid colon may metastasize through lymphatic or hematogenous pathways to distant organs, resulting in significant structural and functional alterations. The current case highlights extensive morphological changes that can occur with advanced metastatic adenocarcinoma.

Methods:

A 58-year-old African American female with documented metastatic adenocarcinoma of the sigmoid colon was dissected during a routine gross …

Case Report Highlights Disproportionate Health Outcomes Of Rheumatoid Arthritis In Patients Of Lower Socioeconomic Status, Victoria Pfennig, Karen Vega

Research Day

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the synovial lining of joints and may lead to progressive joint destruction, disability, and premature mortality if inadequately treated. Increasing evidence demonstrates that social determinants of health, particularly socioeconomic status (SES), significantly influence disease outcomes in patients with RA. Studies have shown that individuals of lower SES experience higher disease activity scores, greater physical disability, and poorer quality of life compared with patients of higher SES. Additionally, lower SES has been associated with longer delays between diagnosis and initiation of disease-modifying antirheumatic drugs (DMARDs), contributing to disease progression …

Utilization Review Oversight And Patient Outcomes: A Comparative Analysis Of Utilization Review Oversight Across U.S. States, Jasdeep Singh, Munir Yusuf, Kavya Suryadevera, Kimata Thomas, Aveline Nels, Audrey Arona

Research Day

Introduction: Utilization review processes such as prior authorizations are commonly used by health insurers to manage healthcare utilization in the United States. Although designed to promote cost-effective care and evidence-based treatment, concerns have been raised that these processes may contribute to delays in treatment and increase clinicians' administrative responsibilities. In Georgia, state statutes do not explicitly authorize insurers to make clinical decisions, yet the legal framework provides limited statutory guidance on the extent to which insurers may influence or delay physician-directed care. In contrast, several states have adopted more explicit statutory provisions governing utilization review practices, including requirements for transparency, …

Ai Driven Discovery Of Abaucin: A Novel Narrow-Spectrum Antibiotic Targeting Multidrug Resistant Acinetobacter Baumannii, Joel John, Heanose Takele, Pasang Sherpa, Vicky Mody, Shashidharamurthy Taval

Research Day

The rise of multi drug resistant Acinetobacter baumannii, a pathogen classified by the WHO as a critical priority organism has created an urgent need for innovative antimicrobial therapies. Abaucin is a novel small molecule antibiotic identified through an artificial intelligence driven drug discovery platform. The machine learning platform was used to create a predictive algorithm on 7500 known compounds against A. baumannii to identify structural features associated with bacterial growth inhibition. This algorithm analyzed 6,680 additional compounds from a drug repurposing hub, rapidly identifying several candidates for experimental validation. Anti-bacterial activity screening of 240 selected compounds yielded nine …

Calvarial Thickening In A Cadaver With A History Of Breast Cancer And Terminal Heart Failure, Sara Kurtovic, Jasdeep Singh, Celeste Pak, Erek N. Arsiniega, Diana Peterson

Research Day

Background: The calvaria plays a vital role in protecting the brain and providing attachment sites for cranial muscles. However, its structure may change in response to systemic disease or localized intracranial processes. Calvarial thickening has been associated with a broad range of conditions, including congenital skeletal dysplasias, acromegaly, chronic anticonvulsant use, and neoplastic disease. Breast and lung cancer are known to metastasize to bone, including the skull, where it may induce osteolytic or osteoblastic changes. Bone metastases are common in advanced malignancy and may occur silently, particularly when unrelated to the primary cause of death. For this reason, identification of …

Health Care Practitioners’ Self-Reported Knowledge, Skill Level, And Confidence In Evaluating And Treating Lymphedema And Lymphatic Dysfunctions With Individuals Who Are Pregnant Or Post-Partum, Gem Johnson, Shelley Dicecco, Ria Lewis-Strange, Diana Mehrez

Research Day

The management of lymphedema during pregnancy presents a complex clinical challenge driven by significant physiological shifts, including a 40–50% increase in plasma volume and mechanical obstruction by the gravid uterus. However, current practice relies precariously on oncology-centric models that fail to address these unique hemodynamic demands due to a critical lack of evidence-based guidance. The aim of this study was to investigate the self-reported knowledge, skill levels, and confidence of international health care practitioners regarding the evaluation and treatment of lymphedema in the pregnant and post-partum population.

A mixed-methods international survey was distributed to lymphedema practitioners worldwide in 10 languages …

Recognizing Extrapelvic Disease: A Case Of Umbilical Endometriosis Diagnosed At Laparoscopy, Caroline R. Kebberly, Audrey Arona

Research Day

Background: Extrapelvic endometriosis is defined by the presence of endometrial-like tissue located outside the pelvic cavity and beyond the gynecologic organs. Its true prevalence remains difficult to establish due to limited epidemiologic data, under recognition and frequent diagnostic delay. Umbilical endometriosis represents approximately 30–40% of abdominal wall endometriosis cases and accounts for an estimated 0.5–1.0% of all reported endometriosis diagnoses. Clinical suspicion is typically based on symptomatology, as patients often present with dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility.

Objective: We present a case of umbilical endometriosis, also known as Villar’s nodule, identified during diagnostic laparoscopy performed for suspected pelvic …

The Potential Role Of A Western Diet In Inducing Anxiety Disorder Via Inflammation, Erek N. Arsiniega, Kimberly J. Baker

Research Day

Anxiety disorder is a prevalent mental health condition that affects many individuals in American and other Western societies. Despite its high prevalence, the underlying mechanisms contributing to anxiety disorder remain largely not known, and there are research gaps in this area. Notably, there is an increased pattern of anxiety levels among the general population, with college students being particularly susceptible. Concurrently, there is a growing body of evidence looking into the heightened prevalence of chronic inflammation among individuals in the United States. This rise in chronic inflammation can be attributed, in part, to the dietary practices commonly observed in Western …

Socially Driven Ai Interactions And Youth Mental Health: A Review Of Benefits, Risks, And Research Gaps, Chloe Pak, Celeste Pak, Jasdeep Singh, Ravi Yarid

Research Day

Introduction: The rapidly increasing use of AI driven social interactions in the daily lives of adolescents has called into question the effects of these experiences on youth mental health. The advent of AI technologies like chatbots and social companions has provided easily accessible outlets for younger populations to engage in conversations surrounding sensitive topics and to receive emotional support and advice.

Objective: This primary objective of this study is to examine the impact of AI driven social interactions on adolescent mental health and to investigate the potential benefits, risks, and gaps in literature surrounding AI social technology.

Methods: A systematic …

Acute Salpingitis Presenting As Small Bowel Obstruction, Hayden E. Evans, Nasir L. Abbasi, Audrey Arona

Research Day

Introduction: Small bowel obstruction (SBO) is most commonly caused by postoperative adhesions, hernias, or malignancy. While adhesions typically arise from prior abdominal surgeries, gynecologic inflammatory conditions represent a rare but important etiology. Salpingitis, a manifestation of pelvic inflammatory disease (PID), can lead to pelvic adhesions but is an uncommon cause of mechanical SBO. Recognition of gynecologic sources of SBO is important for proper management and timely surgical intervention. We present a case of acute salpingitis resulting in adhesive band formation between the fallopian tube and the sigmoid colon, leading to mechanical SBO requiring operative management.

Case Presentation: We report the …

From Remodeling To Risk: Cadaveric Evidence Of Cranial Paget’S Disease Of Bone & Neurovascular Implications, Madeleine Gedgoudas, Amaz Ali, Hamna Ali, Atharva Athalye, Benjamin Maggard, Adeshewa Olaiya, Diana Peterson

Research Day

Introduction: Paget disease of bone (PBD) is a metabolic bone remodeling disorder that alters the architecture of multiple bones throughout the body. The disorder affects the axial skeleton at a higher rate and progresses in three phases: osteoclastic activity, osteoblastic activity, and late inactive phase activity. PBD is a slow progression of abnormal bone remodeling where an increase in bone turnover will replace normal lamellar bone with weaker woven bone. We present a case study of Paget’s disease with an enlarged skull. An enlarged skull structure can lead to headaches, hearing impairment due to cranial nerve deficits, ischemic stroke from …

Anatomical And Clinical Relevance Of Quintuple Coronary Artery Bypass, Rohan Patel, Mackwan Sringam, Atharva Athayle, Ethan Cook, Gavin Scott, Rishab Prakash, Jordan Pullins, Diana Peterson

Research Day

Introduction: Coronary artery disease is the leading cause of death worldwide and is an indication for bypass treatment. In most cases, a double, triple, or quadruple bypass grafting surgery is performed to resolve obstructed arteries. The arteries most commonly obstructed are the right coronary (RCA), left circumflex (LCA), and left anterior descending artery (LAD). Additionally, the arteries commonly used to create the bypass graft include the internal thoracic arteries and the great saphenous vein. Quintuple bypass grafting is rare, as five revascularizations, including revascularization of small vessels, are required in order to reroute blood flow around the extensive obstruction of …

Abnormal Attachment Of The Psoas Major Fibers: A Cadaveric Case Report, Su-Ting (Sandy) Lin, Travis Gabbidon, Mehak Sahney, Rishab Prakash, Aleyna Chung, Diana Petrucello

Research Day

Introduction

Anatomical variations of the psoas major are uncommon but may be clinically significant due to their potential relationship with nearby neurovascular structures. Variations in the morphology of the psoas major may have implications for surgical procedures or nerve entrapment syndromes.

Methods

This case report is based on an abnormal splitting of the psoas muscle noted during a routine cadaveric dissection of a 79-year-old female. Pictures were taken to document the abnormality.

Results

The right psoas major had an accessory muscle body that inserted onto the iliacus rather than the lesser trochanter of the femur, which is the typical insertion …

Epigenetics Programming Of T2dm Risk In The South Asian Community And Its Implications For Clinical Practice, Arpita Harapanahalli, Shalini Patibandla, Francis Jenney

Research Day

Background: Type 2 diabetes mellitus (T2DM) occurs at disproportionately higher rates among South Asian populations compared with other ethnic groups, posing significant challenges for disease risk and clinical management. South Asians are also predisposed to central adiposity, demonstrating greater visceral fat accumulation even at lower body mass index levels, which contributes to increased insulin resistance. From a clinical perspective, understanding these genetic and epigenetic influences is incredibly important for improving prevention and adapting care for South Asian communities.

Objectives: This review aims to examine current evidence on epigenetic mechanisms contributing to T2DM risk in South Asian communities and its implications …

Targeting Dysbiosis: Rebyota As A Novel Strategy For Recurrent Cdi Prevention, Christina Cologer, Mishel Alvarez, Sia Christine, Brooklyn Myers, Kaytlin Pal, Katrina Strand, Vicky Mody, Shashidharamurthy Taval

Research Day

Clostridioides difficile is a bacterium that colonizes a patient's gastrointestinal tract after the use of systemic antibiotics. This infection, also called CDI, causes severe diarrhea and can be life-threatening. In some patients, CDI recurs, creating a dangerous cycle. Recurrent CDI (rCDI) persists because systemic antibiotics induce dysbiosis, disrupting the gut microbiota’s metabolic functions and compromising the intestinal epithelial barrier. This study was conducted as a literature review evaluating the safety, efficacy, mechanism of action, and clinical use of Rebyota in preventing rCDI. Rebyota is the first FDA-approved (2023) live biotherapeutic designed to restore eubiosis in adult patients after antibiotic treatment. …

Fluctuating Epidemiology Of Poliovirus In Conflict-Affected Regions: Comparative Trends In Wild-Type And Vaccine-Derived Cases Following Vaccination Campaigns, Rama Khawaldeh, Bryanna Bhakta, Shafik Habal

Research Day

Background

Poliomyelitis is a contagious enteroviral disease caused by poliovirus, which affects the central nervous system and causes irreversible paralysis. Two distinct forms of poliovirus exist today: wild poliovirus type 1 (WPV1), the naturally occurring virus associated with epidemics, and vaccine-derived poliovirus type 2 (cVDPV2), which arises when the weakened strain in the oral polio vaccine mutates and regains virulence in under-immunized communities. Since the start of the Global Polio Eradication Initiative (GPEI) in 1988, global incidence of WPV1 has declined due to widespread vaccination campaigns. However, sporadic cVDPV continues to occur, more often in conflict-affected regions where population displacement …

Critical Analysis Of Psychiatric Medications, And Their Effects On Patients With Post-Orthostatic Tachycardia Syndrome(Pots), Joshua Lovelock, Michael Gibson, Fernando Izaguirre, Daniel Hong

Research Day

Background: Postural Orthostatic Tachycardia Syndrome (POTS) is a form of autonomic dysfunction defined by an excessive increase in heart rate (>30bpm within 10 minutes) upon standing and symptoms such as lightheadedness, palpitations, and, in some cases, syncope. Because many POTS symptoms overlap with those of anxiety and depression, psychiatric medications are commonly considered, but there’s a risk they may affect the heart rate and blood pressure.

Objective: To summarize how common psychiatric medication classes may impact autonomic function in patients with POTS.

Methods: This project reviewed the autonomic effects of antidepressant classes (SSRIs, SNRIs, TCAs) from peer reviewed articles. …

The Use Of Manual Therapy For Thoracic Spine Symptoms: A Scoping Review, Grace Wolf, Gabrielle Hoffman, Daniel W. Mackie, Scott Lowe

Research Day

Introduction/Background:

Manual Therapy, including Osteopathic Manipulative Medicine (OMM), Manual Physical Therapy, and chiropractic, is frequently applied to the thoracic spine; however, no published review examines the role of manual therapy in treating thoracic spine symptoms. Literature reviews indicate that much of the research focused on thoracic spine manual therapy is focused on outcomes for other body regions, in particular the cervical spine and upper extremities.

The purpose of this research is to determine what evidence exists to show the effect of manual therapy on musculoskeletal thoracic symptoms. Additionally, gaps in the research and directions for future inquiry will be identified. …

Anatomical And Clinical Relevance Of Hepatomegaly Alongside Metastatic Adenocarcinoma Of The Sigmoid Colon, Mackwan Sringam, Rohan Patel, Atharva Athalye, Rishab Prakash, Ethan Cook, Gavin Scott, Jordan Pullins, Diana Peterson

Research Day

Introduction: Colorectal cancer is one of the most common forms of cancer around the world, and is the leading cause of cancer-related death. The majority of these are adenocarcinomas, and one common issue of adenocarcinomas is metastasis to the liver. Generally, this is caused through the hepatic portal vein which drains venous blood into the liver.

Objective: The primary objective of this case study is to present the anatomical findings and clinical significance of hepatomegaly due to metastasis of adenocarcinoma in the sigmoid colon.

Methods: Routine dissection of the cadaver was performed during anatomy lab and then photos of the …

From Zebra Bite To The Operating Room: Discussion Of The Management Of Equine Bite Wounds, Kavya Suryadevara, Harshita Yepuri, Saad Rahman, Milo Paman, Gehrig Ornelas, L. Michael Waters Jr

Research Day

Animal bites, particularly those from cats and dogs, are well characterized in emergency and surgical care. Equine animal bites, however, are rare and may be underestimated in severity. The genus Equus includes animals such as horses, donkeys, and zebras, with members sharing similar dental and digestive anatomy as well as comparable musculoskeletal traits. These animals generate significant crushing forces, often causing deep soft-tissue injury, devitalization, and extensive contamination with complex oral flora. For surgeons, such wounds present challenges in assessment, irrigation, debridement, and closure, as well as antimicrobial selection to prevent infection. Despite potential severity, equine bite cases are infrequently …

Treatment Of Carotid Artery In-Stent Restenosis Using A Drug Eluting Balloon Combined With The Transcarotid Artery Revascularization Flow Reversal System, Harshita Yepuri, Saad Rahman, Ishaa Dubey, Daniel J. Badia

Research Day

Introduction

In-stent restenosis (ISR) after carotid artery stenting presents a unique challenge to the vascular surgeon. While carotid endarterectomy remains the gold standard for symptomatic carotid stenosis, this option is often difficult in the setting of ISR, as stent extraction may require arterial reconstruction or interposition bypass. Drug-coated balloon (DCB) technology has demonstrated success in treating ISR in the lower extremities by reducing neointimal hyperplasia through paclitaxel-mediated inhibition of smooth muscle proliferation. Transcarotid artery revascularization (TCAR; Silk Road) has gained popularity due to its favorable safety profile, short learning curve, and reliable neuroprotection via flow reversal, as demonstrated in the …

Uremic Striatopallidal Syndrome: A Rare Cause Of Hyperkinetic Movement Disorder In End-Stage Renal Disease, Cohen Chong, Esther Choi, Bhavi Purohit

Research Day

Introduction

Uremic striatopallidal syndrome (USPS) is a rare neurologic complication of end-stage renal disease (ESRD) characterized by bilateral basal ganglia dysfunction and hyperkinetic movement disorders, which may manifest as chorea, dystonia, or parkinsonian features. The underlying pathophysiology is not fully understood but is thought to involve metabolic derangements, uremic toxin accumulation, and disruption of basal ganglia function. Because its presentation can mimic medication-induced symptoms, primary neurodegenerative conditions, or other metabolic encephalopathies, USPS may be underrecognized and misdiagnosed, leading to delays in appropriate management.

Methods

A retrospective review of clinical findings, laboratory data, imaging studies, and hospital course was performed for …

Recurrent Seizure-Like Episodes Revealing Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis: A Case Report, Cohen Chong, Esther Choi, Bhavi Purohit

Research Day

Introduction

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto encephalopathy, is a rare autoimmune condition characterized by encephalopathy, seizures, cognitive impairment, and neuropsychiatric manifestations in the presence of elevated antithyroid antibodies. The estimated prevalence is approximately 2.1 per 100,000 individuals, and the condition remains underrecognized due to its highly variable clinical presentation. Neuroimaging is often normal, and electroencephalography typically demonstrates nonspecific abnormalities such as diffuse slowing. Additionally, thyroid antibody testing is not routinely included in the evaluation of seizure-like activity or unexplained encephalopathy, which may delay diagnosis. As a result, SREAT is often diagnosed only after extensive …