20 year old man:
- Was at the cinema with mates; watching Saw 49
- Began to feel unwell – nausea
- Need the toilet
- Got up, felt “rubbish” and then collapsed
- Witness states – “had a fit”
- Lost control of bladder
- Came around after a minute
- Felt “crap”
This presentation falls beneath the umbrella of fits, faints, and funny turns. When thinking about loss of consciousness, it is important to have a clear idea about what about before, during, and after the event as this will help us differentiate between causes. It is also vital to get a clear description of the “fit”.
A reasonable summary of the case so far might be:
“An acute neurological disorder characterised by transient loss of consciousness and urinary incontinence , preceded by nausea and standing, and followed by feeling generally unwell”.
What other questions might you want to ask?
How could you get more information?
What would you expect to find on examination?