The Unconscious Patient

Introduction An unconscious patient is an unresponsive patient who may also have breathing and circulatory problems. This may be neurological or may result from other systemic diseases. An easy way of finding the cause is to think in terms of the vowels: AEIOU A Apoplexy (stroke) E Epilepsy I Infections e.g. meningo-encephalitis O: Overdosing with … Read more


Introduction Syncope is synonym to: Fainting. It is a  loss of consciousness and postural tone as a result of diminished cerebral blood flow. It may be due to vaso-vagal attack or Cardiac causes. It may result from Prolonged standing, severe emotional disturbance, site of blood (e.g. witnessed by medical student for the first time in … Read more


Introduction Stroke is synonyms to: Brain attack, Cerebrovascular disease, and Apoplexy. It is a condition resulting from disruption of blood supply to brain cells (either occlusion (infarction) or blood vessel rupture (haemorrhage). There should be pathological and/or radiological demonstration of the lesion. The disability may result in death. The duration of disability is no longer … Read more

Seizures/ Epilepsies

Introduction A seizure results from abnormal excessive electrical discharge of brain cells. Epilepsy is a condition characterized by recurrent seizures unprovoked by any immediate identifiable cause. It may be idiopathic or could follow: Cerebral infections Metabolic derangements (glucose, electrolytes, fluids) Stroke Tumours Head trauma Birth injury/asphyxia Drug abuse/overdosage/withdrawal Alcoholism Neuro-degeneration Clinical features Classical attack with … Read more


Introduction Parkinsonism is synonyms to ‘shaking palsy’; ‘paralysis agitans’; ‘akinetic-rigid syndrome’. A common neuro degenerative disease that results from deficiency of the neurotransmitter dopamine, in the striato nigral pathway. The idiopathic variety is called Parkinson’s disease while parkinsonism is used when an aetiologic agent is found Causes: Drugs Antipsychotics e.g. phenothiazines Antihypertensives: alpha methyl dopa, … Read more


Introduction Migraine is headache resulting from changes in the calibre of certain blood vessels in the brain with resulting physical, autonomic and emotional disturbance. It can be very incapacitating. Each headache attack lasts for a few hours to a maximum of 3 days but can be aborted with appropriate intervention. It affects more females than … Read more


Introduction Meningitis is an infection of the meninges with the presence of pus and inflammatory cells in the cerebrospinal fluid. It is a medical emergency, and associated with considerable morbidity and mortality. It may be bacterial (pneumococcus, meningococcus, tubercle bacilli, Haemophilus), viral, fungal, protozoal, neoplastic or chemical. Organism may vary with age of the patient. … Read more


Introduction Headache is defined as pain or discomfort in the head and the surrounding structures of the head. They may be: Primary (idiopathic) Secondary Primary headache types Tension type Migraine with or without aura Cluster headache Secondary causes Intracranial space-occupying lesions like brain tumours, subdural haematoma Vascular lesions: strokes Infections Following generalized convulsions Metabolic derangements … Read more


Introduction Dizziness is an altered sense of balance and place, possibly described as lightheaded, feeling faint or as if head is spinning. It simply means ‘light-headedness’. It usually due to impaired supply of blood, oxygen and glucose to the brain It may suggest some form of unsteadiness, or could precede a fainting spell. Causes: Side … Read more