i HAVE A PATIENT WHO IS 81YRS OLD, FAIRLY HEALTH AND ACTIVE, DIABETIC, WHO IS EXPERIENCING EXTREME INTERNAL COLD/FREEZING SPELLS. SHE HAD A HEAD CT SHOWING POSSIBLE STROKE , MRI RESULTS LEAN TOWARD POSSIBLE SEIZURE ACTIVITY. AN EEG WAS JUST DONE BUT NO RESULTS YET. WHEN SHE IS HAVING AN EPISODE SHE WILL BECOME TACHICARDIC, CONFUSED AND THEN DROWSY. SHE DENIES PAIN OR SOB. IS THIS AN UNUSUAL EXAMPLE OF SEIZURE ACTIVITY OR DO YOU HAVE ANY OTHER DIFFERENCIAL DIAGNOSIS?
Dear friend, welcome to Chat Doctor.a well asked query indeed !it looks like a seizure with sympathetic overactivity, and post octal state like Chat Doctor. Does she periodically get better?does the MRI show an infarct/ diffusion restriction?how long back was the onset of episode?any paresis?you can give iv midazolam under preparedness, under competent medical supervision and see if it aborts the episodes, confirming the seizure. EEG may / may not show it.pl. take a euro consult, if you are not able to decide further. Pl. post the results and greater details of the entire illness and would be glad to revert. She should be in an ICU. Good luck.