A 42-year-old male was admitted to the emergency room at 3 a.m. after experiencing sudden severe abdominal pain, sweating, an urgent need to defecate, and an inability to stand or walk. The patient also had a transient loss of consciousness lasting 5-10 minutes, during which he involuntarily passed urine and stool. The patient was quickly brought to Orange City Hospital, where he was conscious, oriented, and able to follow commands upon arrival. Despite no abdominal pain or neurological deficits at the time of admission, the patient complained of generalized weakness.
The patient reported similar episodes occurring 4-5 times over the past 10-12 years, although none of the episodes was further evaluated. His medical history was otherwise unremarkable, with no significant family or comorbid conditions.
The patient was evaluated under the care of Senior Critical Care Physician Dr. Rajesh Atal, with a detailed work-up revealing no abnormalities. Routine blood tests, CT brain, ultrasound of the abdomen, ECG, and 2D Echo all returned normal results. Given the onset of symptoms with abdominal pain, the opinion of Gastroenterologist Dr. Rachit Agrawal was sought, and a CECT abdomen was performed to rule out any vascular abnormalities or calculi, which were also found to be normal.
As the patient had experienced unconsciousness, Neurologist Dr. Kedar Takalkar conducted a thorough evaluation. After reviewing the history and clinical symptoms, a diagnosis of Temporal Lobe Epilepsy was established. To further rule out any organic causes, an EEG and MRI brain with an epilepsy protocol were performed, both of which showed no abnormalities.
Dr. Usha Nair, Manging Director mentioned that the complex nature of the patient’s presentation posed challenges, but the coordinated approach of the medical team at Orange City Hospital, involving multiple specialists, ensured a comprehensive diagnosis and treatment plan. The patient was started on antiepileptic medication and discharged in stable condition, with counseling on the importance of regular follow-up appointments and medication adherence.
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