sudden neuro events and syncope Flashcards
A previously healthy 17 year-old woman presents having lost consciousness in church 4 weeks ago. She initially felt light-headed and sick, and was described by witnesses as being pale and sweaty. These symptoms lasted 3 minutes. She ‘flapped’ to the ground and has described as having ‘jerked’ three times. She recovered rapidly with no confusion or dizziness. The symptoms have not recurred.
vasovagal syncope
A 32 year-old woman complains of two events characterised by spreading tingling and numbness from her left hand to her face lasting 20-25 minutes. There were both followed by a severe headache, nausea and vomiting. She was photophobic and felt ‘hot’, but her temperature was not raised. Her sister (a staff nurse) has suggested she takes aspirin to stop further ‘mini strokes’ occurring.
migraine with aura
A 68 year-old man with a history of MI and hypertension presents with two episodes of altered consciousness. During both episodes, he collapsed suddenly, and was pale and grey. He recovered quickly, with pink flushing of the skin. He had recently complained of being aware of his heart beating faster, and a sensation he felt in his chest and neck.
cardiac dysrhythmia
A 35 year-old complains of recurrent stereotyped events that have occurred four times in the last two months. The initial symptom is of a pain in her abdomen, with pallor noticed by witnesses. She then falls backwards and appears to witnesses to have lost consciousness. Her lips and tongue are noted to be moving, and she makes ‘smacking’ noises. She recovers slowly and seems confused and sleepy for some hours.
complex partial seizure
A 19 year-old man complains of severe headache (“the worst of my life”) and photophobia with onset gradually over the preceeding 5 hours. His mother feels that he is confused. His temperature is 38.3oC and he has a stiff neck on examination.
bacterial meningitis
