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Blackouts (Unwell patients (Metabolic (Electrolyte imbalance,…

- - - - Iatrogenic
        -Vasodilators, Anti-hypertensives, Anti-depressants, Diurectics
      - Autonomic Failure
        -Neurodegenerative dz
        -DM
      - Volume Depletion
        -Hyperglycemic polyuria, GIT fluid losses, drugs, adrenal insufficiency
    - - Vagovagal
        -Provoked by emotion, pain, fear, prolonged standing, dehydration
      - Situational
        -A/w micturition, cough, defecation, swallowing, carotid sinus massage
    - - Arrhthmias
        
        Tachycardia
        
        Channelopathies
        
        Brugada syndrome
        
        Wolff-Parkinson-White
        
        Long QT syndrome
        
        Bradycardia
        
        Sinus dysfunction
        
        AV block
      - Structural
        
        Right-sided obstruction
        -PE, Tetrology of Fallot
        
        Poor cardiac function
        -IHD, acute MI, Cardiomyopathy, Pericardial Effusion
        
        Left-sided obstruction
        -aortic stenosis, mitral stenosis, HOCM, defective prosthetic valve
        
        Aortic dissection
        -Chest pain & syncope
  - - - Generalized Seizure
        
        Type
        
        Generalized tonic clonic
        1) tonic stiffening, biting of tongue, apnoea, sympathetic tone, BP & HR
        2) Clonic limb jerking
        3) Post-ictal drowsiness ± incontinence
        
        Absence Seizure
        -stares blankly into space <10 s
        
        Pure Clonic
      - Focal (Partial) Seizure
        
        Simple Partial Seizure
        -Gaze deviation, hand jerking, Todd's paralysis
        -Parasthesia(sensory cortex)
        -Flashing lights (occipital cortex)
        -Auras (temporal /frontal cortex)
        
        Complex Partial Seizure
        -LOC
        -accompanied by automatisms(lips making,dystonia,handmovement)
        -Post-ictal amnesia
      - Etiology
        
        Irreversible
        
        Structural
        
        Mass lesion, e.g. brain tumour
        
        Degenerative
        
        Scarring
        
        Congenital
        
        Reversible
        
        Metabolic
        -Stat hypo count for metabolic derangement
        
        Drugs
        -TCA, cocaine, alcohol, Benzodiazepine withdrawal
        
        Infective
        -Meningitis, Encephalitis, Cerebral abscess, parasitic dz
        
        Stroke
        
        Acute Trauma