House M.D. - Season 1, Episode 2

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That twitch in your leg. Did you feel that?
That twitch in your leg.
Did you feel that?
Didn't hurt. His leg twitched. I don't see what--
- Didn't hurt.
- His leg twitched.
I don't see what--
It's called a myoclonic jerk. It's very common when you're falling asleep
It's called a myoclonic jerk.
It's very common
when you're falling asleep.
Respiration rate falls, and the brain sometimes interprets this as the body dying, so it sends a pulse to wake it up
Respiration rate falls, and the brain
sometimes interprets this as the body dying,
so it sends a pulse to wake it up.
So? So, he's not asleep
- So?
- So, he's not asleep.
He's awake
He's awake.
Admit him
Admit him.
I recognize that loopy "G"
I recognize that loopy "G".
So, what does the jerk tell us?
So, what does the jerk tell us?
Nothing good. The brain's losing control of the body
Nothing good.
The brain's losing control of the body.
Can't order the eyes to focus, regulate sleep patterns or control muscles
Can't order the eyes to focus,
regulate sleep patterns
or control muscles.
A movement disorder or a degenerative brain disease
A movement disorder
or a degenerative brain disease.
Either way, this kid's gonna be picking up his diploma in diapers and a wheelchair
Either way, this kid's gonna be
picking up his diploma
in diapers and a wheelchair.
Maybe not that bad. Could be an infection
Maybe not that bad.
Could be an infection.
You wish. No fever, no white count
You wish.
No fever, no white count.
Anyone think this differential diagnosis might be compromised because we don't have an accurate family history?
Anyone think this differential diagnosis
might be compromised because
we don't have an accurate family history?
I took an accurate family history. You didn't even take an accurate family
- I took an accurate family history.
- You didn't even take an accurate family.
His father's not his father. Why would you say that?
- His father's not his father.
- Why would you say that?
Thirty percent of all dads don't realize they're raising someone else's kid
Thirty percent of all dads
don't realize they're raising
someone else's kid.
False paternity's more like 10%. That's what our moms would like us to believe
False paternity's more like 10%.
That's what our moms
would like us to believe.
Who cares? If he got it from his parents, they'd both be dead
Who cares?
If he got it from his parents,
they'd both be dead.
Can we get on with the differential diagnosis? Fifty bucks says I'm right
- Can we get on with
the differential diagnosis?
- Fifty bucks says I'm right.
I'll take your money. Hit a nerve?
- I'll take your money.
- Hit a nerve?
Don't worry. I'm sure the guy who tucked you in was your daddy. Make it a hundred
- Don't worry. I'm sure the guy who
tucked you in was your daddy.
- Make it a hundred.
What about leukoencephalopathy in a 16-year-old?
What about leukoencephalopathy
in a 16-year-old?
It doesn't necessarily have to be that bad
It doesn't necessarily
have to be that bad.
If we exclude the night terrors, it could be something systemic
If we exclude the night terrors,
it could be something systemic.
His liver, kidneys. Something outside the brain. Yes
- His liver, kidneys.
Something outside the brain.
- Yes.
Feel free to exclude any symptom if it makes your job easier. Night terrors were anecdotal
- Feel free to exclude any symptom
if it makes your job easier.
- Night terrors were anecdotal.
He could've had a bad dream. No. Parents said he was conscious during and didn't remember anything afterwards
- He could've had a bad dream.
- No. Parents said he was conscious during
and didn't remember anything afterwards.
That's a night terror. Parents said?
- That's a night terror.
- Parents said?
That's a good point
That's a good point.
Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism
Before we condemn this kid,
maybe we should entertain
Dr. Chase's skepticism.
I want a detailed polysomnograph. If he's having night terrors, I want to see them
I want a detailed polysomnograph.
If he's having night terrors,
I want to see them.
I usually don't move during night terrors
I usually don't move
during night terrors.
I'm not restraining you for them
I'm not restraining you for them.
E.E.G. revealed abnormalities in your brain--
E.E.G. revealed abnormalities
in your brain--
caused nerve damage in your toes
caused nerve damage in your toes.
What are you doing?
What are you doing?
Fixing it. Can I talk to my parents?
- Fixing it.
- Can I talk to my parents?
Oh, they know all about this
Oh, they know all about this.
I'd really like to see them
I'd really like to see them.
Please. I'd really like them here
Please. I'd really like them here.
This is gonna hurt, Dan
This is gonna hurt, Dan.
Oh. Oh, God
Oh. Oh, God.
That's a night terror
That's a night terror.
We did a C. T., M.R.I., C.B.C., CHEM-7 and chest X-ray
We did a C. T., M.R.I., C.B.C.,
CHEM-7 and chest X-ray.
All the tests came back normal. There's nothing to explain his symptoms
All the tests came back normal.
There's nothing to explain his symptoms.
Okay, but let's pretend there's something and go from there. Who sees something on this M.R.I.?
Okay, but let's pretend
there's something and go from there.
Who sees something on this M.R.I.?
No lesions in the white matter. No structural abnormalities
No lesions in the white matter.
No structural abnormalities.
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