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Falls - Coggle Diagram
Falls
LoC / Pre-Syncope (4S)
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Seizure
Look for Aura and post ictal signs
Aura: deja vu, strong emotion, abnormal sensation
Must ask duration
Post Ictal Signs:
Incontinence?
Long Recovery Period?
Bite down on your tounge and lip? - pain & blood in mouth
Post ictal drowsiness: very dazed, dk how to do anything
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Characteristics:
Jerking
Absence
Uprolled eyes
RFs:
DHx, Stroke
Precipitated by:
Alcohol
Bright lights, sensory overload
Stroke
Headache (5 minutes to worst headache of life)
Cortical Signs - apraxia, agnosia, aphasia
Vision Changes
Facial Droop
Dysarthria
Dysphagia
Generalised one-sided weakness
Loss of sensation
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Metabolic
SUGAR
Hypoglycaemia:
Intermittent meals, termors, palpitations, sweating
RF:
FHx T1DM
Overdose of insulin and sulfonylureas
Precipitating Factors:
When was their last meal?
DHx:
Beta blockers mask symptoms of hyoglycaemia
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Dizziness
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Is the room spinning
Duration
seconds to minutes: BPPV - vertigo on postural change, always when they move their head in the same position
Minutes to hours: Menieire's - Vertigo, Hearing loss, aura / tinnitus
Vestibular Migraine - migraine-like headaches, same triggers
Hours to Days: Acute labyrinthitis - hearing loss
Vestibular neuritis - no hearing loss
Vestibular neuritis is due to URTI
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Characterise:
Anyone see you fall?
Recurrent?
Since when?
LoC?
Instability?
Point of impact? - look for head injury
Time Course:
Pre-Fall
Fall
Post-Fall
MUST ASK: TRO Mechanical fall, ASK Recurrent fall