Spells of confusion

Authors: Ivana Lutchman/ Editor: Steve Corry-Bass / Reviewer: Haitham Hodhod / Codes: / Published: 06/06/2022

A 69-year-old gentleman presented to the emergency department with odd periods of vacancy. His wife reported that on the previous day, he had 2 episodes in which he would become suddenly pale and confused for 20 to 30 seconds.

During the episodes there was abnormal lip smacking movements and on one occasion he developed left sided facial weakness. He has no recollection of any of these episodes.

His past medical history includes hypertension, osteoarthritis and a left hip replacement. His medications are Bendroflumethiazide and Losartan.

On examination there were no focal neurological deficits.

His observations were:

RR: 18

Oxygen Saturations: 94%

HR: 48

BP: 141/80

GCS 15

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