Causes of fits
| Cause of fit | Clinical clues |
|---|---|
| Epilepsy | Previous history of epilepsy |
| Concurrent illness eg, infection | |
| Changes in medication | |
| Non-compliance with medication | |
| CNS infection | History of recent illness/headache |
| Meningitis | Rash |
| Encephalitis | |
| Head injury | History of recent trauma |
| Evidence of scalp bruising, swelling etc. | |
| Vascular | |
| Stroke (new or old) | May be focal neurological signs |
| Subarachnoid haemorrhage | |
| Intracerebral haemorrhage | |
| Metabolic | |
| Hypoglycaemia | Always check blood glucose |
| Hyponatraemia | |
| Hepatic encephalopathy | Patient jaundiced |
| Poisoning | |
| Alcohol | ?smell of alcohol |
| Tricyclic antidepressants | history of mental illness |
| Mefenamic acid | empty tablet bottles |
| Miscellaneous | |
| Alcohol withdrawal | Known alcoholic who doesn’t smell of alcohol |
| Eclampsia | Patient pregnant |
| Malignant hypertension | Diastolic BP >110 mmHg |
| Intracerebral tumour or metastases | History of malignancy |