Causes and diagnosis of unconsciousness

2016 ◽  
Author(s):  
Robert D. Stevens ◽  
Joshua Kornbluth
Keyword(s):  
Differential Diagnosis ◽  
Brain Lesions ◽  
Loss Of Consciousness ◽  
Neurologic Examination ◽  
Metabolic Disturbances ◽  
Environmental Stimuli ◽  
Generalized Seizures ◽  
Neuronal Systems

Changes in consciousness are seen in a range of physiological and pathological settings including sleep, anaesthesia, brain lesions, metabolic disturbances, and complex partial or generalized seizures. In neurobiological terms, consciousness may be viewed as having an arousal dimension and an awareness dimension phenotypically expressed as the capacity to respond to self or environmental stimuli. Loss of consciousness is associated with lesions that disrupt neuronal systems in the brainstem and diencephalon that mediate arousal or thalamocortical or corticocortical systems that mediate awareness. As there are many causes of unconsciousness, a timely and focused history and neurologic examination are critical to defining the differential diagnosis.

Multifocal Oligodendroglioma in Three Dogs

2011 ◽  
Vol 47 (5) ◽  
pp. e77-e85 ◽  
Author(s):  
Michael W. Koch ◽  
Melissa D. Sánchez ◽  
Sam Long
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Seizure Activity ◽  
Clinical History ◽  
Brain Lesions ◽  
Behavior Changes ◽  
Neurologic Examination ◽  
Imaging Findings ◽  
Histopathologic Evaluation ◽  
And Behavior

This report describes the clinical, histopathologic, and imaging findings of multifocal oligodendrogliomas from three canine patients. Clinical history varied but included seizure activity and behavior changes. Neurologic examination abnormalities included ataxia, proprioceptive deficits, cranial nerve deficits, and changes in mentation. MRI in one patient revealed multifocal brain lesions; however, the MRI was normal in another one of the patients. Histopathologic evaluation identified multifocal neoplastic infiltrates in all three patients involving the cerebral cortex, brainstem, and spinal cord, with leptomeningeal extension in two of the three patients. All three patients were euthanized due to progression of their neurologic condition and/or complications due to aspiration pneumonia. Oligodendrogliomas should be considered a differential diagnosis for patients with multifocal brain disease.

scholarly journals Recognizing Syncope: Pitfalls and Surprises

1996 ◽  
Vol 89 (7) ◽  
pp. 372-375 ◽  
Author(s):  
T Lempert
Keyword(s):  
Creatine Kinase ◽  
Differential Diagnosis ◽  
Head Injury ◽  
Muscle Activity ◽  
Epileptic Seizures ◽  
Accurate Information ◽  
Loss Of Consciousness ◽  
Mere Presence ◽  
Key Features ◽  
Premonitory Symptoms

Loss of consciousness and falling are the key features of syncope. Common accompaniments include tonic and myoclonic muscle activity, eye deviations, automatisms, vocalizations and hallucinations which may render the distinction from epileptic seizures difficult. Differential diagnosis is based on the specific features and not the mere presence of these phenomena. Recognition of syncope depends also on accurate information about precipitants, premonitory symptoms and postictal events: the absence of postictal confusion has been identified as the single most powerful factor discriminating syncope from epileptic seizures whereas incontinence and head injury are common in both conditions. Investigations such as electroencephalogram, tilt testing and postictal prolactin or creatine kinase levels may be helpful but are never diagnostic in isolation. Exceptionally, hypoxic and epileptic mechanisms interact within a single attack.

The Neurologic Examination

2018 ◽  
pp. 1-41
Author(s):  
Andrea C. Adams
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Diagnostic Tests ◽  
Neurologic Examination ◽  
Neurologic Symptoms ◽  
Appropriate Therapy

The neurologic examination is the most important part of the evaluation of a patient who has neurologic symptoms or disease. The information obtained from the history and physical examination is needed to generate a differential diagnosis, to select the appropriate diagnostic tests, and to initiate appropriate therapy.

Seizures

2018 ◽  
Author(s):  
Dirk Bäumer
Keyword(s):  
Differential Diagnosis ◽  
Neuronal Activity ◽  
Brain Region ◽  
Diagnostic Tests ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
Focal Seizures ◽  
Generalized Seizures ◽  
The Brain

Seizures are transient neurological events caused by abnormal excessive or synchronous neuronal activity in the brain. This can arise from a localized brain region, causing focal seizures, or simultaneously from both hemispheres, leading to generalized seizures. Epilepsy is the tendency to develop recurrent seizures and is usually diagnosed after two or more unprovoked seizures. This chapter covers simple partial seizures (sometimes called aura), complex partial seizures, and focal (or partial) seizures, their differential diagnosis, context, approach to diagnosis, key diagnostic tests, therapy, and prognosis, as well as dealing with uncertainty in a diagnosis.

scholarly journals The spectrum of paroxysmal dyskinesias

2019 ◽  
Vol 14 (3) ◽  
pp. FNL26 ◽  
Author(s):  
Raquel Manso-Calderón
Keyword(s):  
Differential Diagnosis ◽  
Loss Of Consciousness ◽  
Paroxysmal Kinesigenic Dyskinesia ◽  
Appropriate Treatment ◽  
Key Points ◽  
Paroxysmal Disorders ◽  
Diagnostic Work ◽  
Work Up ◽  
Diagnostic Work Up

Paroxysmal dyskinesias (PxD) comprise a group of heterogeneous syndromes characterized by recurrent attacks of mainly dystonia and/or chorea, without loss of consciousness. PxD have been classified according to their triggers and duration as paroxysmal kinesigenic dyskinesia, paroxysmal nonkinesigenic dyskinesia and paroxysmal exertion-induced dyskinesia. Of note, the spectrum of genetic and nongenetic conditions underlying PxD is continuously increasing, but not always a phenotype–etiology correlation exists. This creates a challenge in the diagnostic work-up, increased by the fact that most of these episodes are unwitnessed. Furthermore, other paroxysmal disorders, included those of psychogenic origin, should be considered in the differential diagnosis. In this review, some key points for the diagnosis are provided, as well as the appropriate treatment and future approaches discussed.

scholarly journals Nonsuppurative Meningoencephalitis Associated with Aleutian Mink Disease Parvovirus Infection in Ranch Mink

2000 ◽  
Vol 12 (2) ◽  
pp. 159-162 ◽  
Author(s):  
N. W. Dyer ◽  
B. Ching ◽  
M. E. Bloom
Keyword(s):  
Polymerase Chain Reaction ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Viral Genome ◽  
Brain Lesions ◽  
Chain Reaction ◽  
Mesenteric Lymph ◽  
Neurologic Disorders ◽  
Polymerase Chain ◽  
Ranch Mink

Severe nonsuppurative meningoencephalitis associated with Aleutian mink disease parvovirus (ADV) infection was observed in adult ranch mink. Brain lesions included severe, locally extensive to coalescing lymphoplasmacytic meningoencephalitis with accompanying gliosis, satellitosis, and mild extension of inflammation into the leptomeninges. ADV was identified in mesenteric lymph node, spleen, brain, and liver of affected mink by polymerase chain reaction techniques. Sequences of the ADV isolate (TH5) revealed 2 unique residues in the region of the viral genome that determines pathogenicity. These findings suggest that certain strains of ADV may preferentially cause disease in the nervous system. ADV infection should be considered in the differential diagnosis of neurologic disorders in mink.

scholarly journals Giperkortitsizm i metabolicheskiy sindrom: slozhnosti differentsial'noy diagnostiki i lecheniya

2012 ◽  
Vol 9 (2) ◽  
pp. 57-61 ◽  
Author(s):  
L K Dzeranova ◽  
Yu V Pankratova ◽  
Z E Belaya ◽  
E A Pigarova ◽  
O V Manchenko ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Differential Diagnosis ◽  
Clinical Case ◽  
Fat Distribution ◽  
Specific Weight ◽  
Pathological Changes ◽  
Metabolic Disturbances ◽  
Endocrine Disorder ◽  
Specific Approach ◽  
Lipids Metabolism

Hypercortisolism is a severe endocrine disorder that leads to all types of metabolic disturbances. The most frequent symptom of hypercortisolism is a specific weight gain and body fat distribution - "cushingoid" obesity which clinically reflects the pathological changes in protein, carbohydrate and lipids metabolism. We provide a clinical case of a patient with Cushings disease. This clinical case represents challenges in the differential diagnosis of this rare endocrine disorder and metabolic syndrome, and specific approach in further evaluation and treatment of Cushing's disease that requires all the latest technology in this field to be employed.

scholarly journals An unusual case of loss of consciousness: when an epileptic brain let the heart slow down

2012 ◽  
Vol 6 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Giovanni Assenza ◽  
Federica Assenza ◽  
Giovanni Pellegrino ◽  
Mario Tombini
Keyword(s):  
Differential Diagnosis ◽  
Unusual Case ◽  
Muscular Activity ◽  
Neurological Symptoms ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Transient Loss ◽  
Polygraphic Recording ◽  
Electroencephalographic Activity ◽  
Panayiotopoulos Syndrome

The differential diagnosis of an episode of transient loss of consciousness can be sometimes very tricking, in particular when symptoms peculiar of syncope are mixed with focal neurological symptoms. We report the case of a 54-year-old woman who suddenly claimed, during a polygraphic recording (electroencephalography/electrocardiogram), a feeling of fear and tachycardia followed by loss of consciousness and then a tonic posturing of the left limbs. Polygraphic recording showed a critical electroencephalographic pattern starting from left temporo-zygomatic channels followed after few seconds by a sudden slowing of cortical background activity associated with an episode of asystole, as witnessed simultaneously by electrocardiogram. Muscular activity covered electroencephalographic activity of following minutes. This case provides an opportunity to highlight the existence of rare conditions such as ictal arrhythmias which should be considered in the differential diagnosis of episodes of transient loss of consciousness in particular when dysautonomic and neurological symptoms are intermingled. Autonomic symptoms (vomiting, tachycardia, cyanosis, bradycardia and asystole) may be also more frequent in idiopathic (more rarely symptomatic) epilepsies of childhood (Panayiotopoulos syndrome).

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