48 yo male unresponsive on the floor, acute onset, 2 episodes of generalised tonic-clonic seizures

Hx & RFs: Feeling of deja vu, auras,

amnesia, unusual sensations Medial temporal Vascular malformations
lobe epilepsy
PE: Unusual speech,
impaired consciosuness
Head injury
Hx & RFs: Hypertension, Cerebrovascular
hyperlipidemia, age disease Hx & RFs: Age, dx of dementia etc
Neurodegenerative
Focal Epilepsy PE: Cognitive impairment
Hx: Progressive headaches (worse
in mornings), N/V, seizures, FHx Primary or
metastatic tumors Idiopathic Epid: 60% of epileptic seizures in adults
PE: Focal neurological signs
PP: Common-Arbovirus, meningitis
Hx & RF: Fever, headache, N/V, seizures,
arthropod (eg mosquito/tick)/animal (eg dog/ Hx: TB-exposure (travel/contact
wolves) bites, Hx of cold sores (HSV-1), Hx of history), Dx of TB; Syphilis-MSM,
varicella (VZV), hypersalivation & hydrophobia Chronic unprotected sex, social Hx
(rabies), immunocompromised Hx & RF: Fever, headache (diuse, jolt
Meningitis accentuation), neck stiness, N/V,
PE: Altered mental state, focal neurological
deficits, abnormal reflexes, zoster (dermatomal photophobia, immunocompromised, recent
vesicular rash), rabies (pharyngeal spasms) ENT infection, recent head trauma
Encephalitis Intracranial
Hx: Headache (localised), fever (~50%), N/V, infection PE: Nuchal rigidity, Kernigs sign, Brudzinskis
seizures, recent ENT infection, recent trauma, sign, neurological deficits, papilloedema
recent surgery, immunocompromised
Extradural Hx & RF: Elderly, dx of
PE: Focal neurological deficits, papilloedema abscess osteomyelitis, recent surgery
Brain
Hx: Subacute presentation, initial abscess Subdural Hx: Recent surgery, penetrating injury, meningitis
concussion, cortical lacerations, empyema
followed by drowsiness, progressive Subdural Hx & RF: Recent TIA
worsening headache & confusion hematoma Acute ischemic or PE: Focal neurological signs, often
PE: Papilloedema, Cushings triad - hemorrhagic stroke unilateral, hypertonia, spasticity,
hypertension, irregular breathing, bradycardia Babinski +, hyperreflexia, facial droop
Hx: Thunderclap headache Hx & RFs: FHx of thyroid dx, autoimmune
Neurologic dx, type 1 DM, tachypnea, heat intolerance,
PE: Papilloedema, Cushings triad -
palpitations, anxiety, frequent bowel
hypertension, irregular breathing, bradycardia
Subarachnoid PE: Hyperreflexia, tachycardia, Graves
Hx & RFs: DM, insulin overdose, drug hemorrhage Hyperthyroidism ophthalmopathy, Goitre, diaphoresis
overdose (aspirin), alcohol use
Hx & RF: Progressive weakness,
PE: Hypothermia, tachycardia, tachypnea, easy fatigue, anorexia, N/V
diaphoresis, anxious-looking, confused Hypoglycemia Uremia PE: Tachypnea with shallow depth,
Hx & RF: Old age, renal problems abnormal mental function, muscle atrophy
PE: Hypotension (K imbalance), Metabolic/
K, Mg, Electrolyte Hx & RFs: DM, hyperglycemic triad -
tachycardia, sluggish bowel Endocrine
PO4 imbalances polyphagia, polydipsia, polyuria
movements (hypoK, hypoMg), vomiting
Hyperglycemia PE: Blurred vision, weight
Hx: Prodrome of confusion &
loss, dry mucosal membranes
depressed level of consciousness Hyponatremia
PE: GTC seizures PE: Mydriasis, tachycardia,
PP: After thyroid/parathyroid surgery Cocaine hypertension, increased arousal

Hx: Mental state changes, tetany Hypocalcemia Benzodiazepine

withdrawal Hx & RFs: Dx of psychosis,
PE: Mental state, tetany insomnia, irritability, palpitations
Substance-induced PE: Mydriasis, diaphoresis

Alcohol withdrawal Hx: Chronic heavy alcohol user,

recent use b/w 7-24 hours
Amphetamines PE: Hallucinations, delirium,
diaphoresis, disorientation

PE: Tachycardia, hypertension, hyperthermia,

diaphoresis, mydriasis, arrhythmia, cellulitis

Migraine Cardiac
Convulsive syncope Orthostatic
Seizure mimics Panic attack & anxiety Neural
TIA Neurologic
TGA
Paroxysmal movement disorders
Narcolepsy with cataplexy
Psychogenic nonepileptic seizure