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I Am A RN, My Husband Is 52, Hx Of
Question: I am a RN, my husband is 52, Hx of GERD and HTN. He takes Nexium 40mg qd and Benicar 25/12.5 qd. BP 118/72. Sent to ER Saturday September 8. CT neg an labs WNL. he was lethargic, confused to situation and date. He was fine sunday and Monday. came home from work 4hrs early. Now again has new onset of confusion but not as bad as sunday. CT was of his brain. July 18 dx concussion and there is no changes since july per ct scan. What could I possible be missing. PCP appointment not until Thursday the 13th.
Brief Answer:
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Detailed Answer:
Hi and Welcome to Ask A Doctor service. Thanks for using this app and being patient. I have read your question and here is my advice.
Confusion and lethargy in an otherwise normal person is always of great concern and must be worked out urgently.
There are many causes for the same and we need a detailed evaluation by history and examination howe'ver the following are common things we should nt miss.
If his labs and CT scan was normal , one common reason for confusion is drugs I just wonder if he has any change in his medicine recently or if he as stopped or started any new drugs , or if he has stopped alcohal or other things , withdrawal of which can give such symptoms. This need detlaled history about these things
Other reasons for cinfusion are any abnormalities in blood electrolytes, like low sodium , low are high sugar , clalciilum, liver fictions ,thyroid , renal function etc.These should aslo be cheked .
One more things we shoud be very catious is any brain infection like encephalitis or menengines. specially if he has any fever, headache, or vomiting
Other reason may be like any structural lesionl in brain.Ct scan was normal, mean this may be reassuring amd the concusion may not be the cause Howe'ver Ct scan is not very sensitive. I would personally advise for an MRI of brain to be done .This should be done with contrast.
So the history would be important in his case, but what I understand is that we should not wait for PCP appointment if he has true confusion. as some causes of confusion may need urgent tretment. So you can take him to ER for reassessment. If no serious thinf is there , then he can be seen by a neuralogist for proper assessment and management.
Hopes I have answered your question and I hope this helps you understand your query. Let me know if you have any further question. I would be glad to answer. kind Regards Dr Rahman
Please see detalied answer
Detailed Answer:
Hi and Welcome to Ask A Doctor service. Thanks for using this app and being patient. I have read your question and here is my advice.
Confusion and lethargy in an otherwise normal person is always of great concern and must be worked out urgently.
There are many causes for the same and we need a detailed evaluation by history and examination howe'ver the following are common things we should nt miss.
If his labs and CT scan was normal , one common reason for confusion is drugs I just wonder if he has any change in his medicine recently or if he as stopped or started any new drugs , or if he has stopped alcohal or other things , withdrawal of which can give such symptoms. This need detlaled history about these things
Other reasons for cinfusion are any abnormalities in blood electrolytes, like low sodium , low are high sugar , clalciilum, liver fictions ,thyroid , renal function etc.These should aslo be cheked .
One more things we shoud be very catious is any brain infection like encephalitis or menengines. specially if he has any fever, headache, or vomiting
Other reason may be like any structural lesionl in brain.Ct scan was normal, mean this may be reassuring amd the concusion may not be the cause Howe'ver Ct scan is not very sensitive. I would personally advise for an MRI of brain to be done .This should be done with contrast.
So the history would be important in his case, but what I understand is that we should not wait for PCP appointment if he has true confusion. as some causes of confusion may need urgent tretment. So you can take him to ER for reassessment. If no serious thinf is there , then he can be seen by a neuralogist for proper assessment and management.
Hopes I have answered your question and I hope this helps you understand your query. Let me know if you have any further question. I would be glad to answer. kind Regards Dr Rahman
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Dr. Raju A.T
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