Suggest Treatment For Sudden Onset Of Unconsciousness And Eczema

Brief Answer:
Consultation

Detailed Answer:
Hi XXXXX, thanks for asking from HCM.


I can understand your concern. The sudden spontaneous unconsciousness (Blackout) and flaring of her eczema could be due to

: Syncope due to ear problem like vestibular function problem - Vestibular system maintains balance. If she is having history of ear discharge, pain in ear, repeated attacks of common cold/sore throat, it could be the cause.

Consult ENT specialist to show her ear and for vestibular function evaluation.

: Drop attack - It is a type of epilepsy (fits or seizures). It can occur due to old history of fits, trauma, stress, deficiency (low glucose/electrolytes). It presents as sudden loss of tone in body and falling, transient loss of consciousness after fall, even amnesia (loss of memory) regarding attack, urinary incontinence.

It is very commonly neglected by doctors. It needs to be ruled out by EEG of brain, few blood investigations like Glucose/electrolytes during attack and if doubt, 24h video EEG. Consult neurologist for it.

: Transient ischemic attack - It is usually a old person disease. However, it can occur in young if some births defect in heart/arteries and brain, occurred after workout or exertion. It is sudden temporary decrease in blood supply to brain.

It is evaluated by evaluating cardiac function testing (ECG, ECHO, CT angiography of heart vessels) and brain function (USG Doppler neck, CT angiography of neck). You need to consult physician to rule it out.

: Psychogenic attack - It can be suspected if all other causes have been ruled out and she was under stress/known case of psychiatric illness/on some drugs/major life event like death in family. You can suspect it more if you have noticed recent change in her behaviour, mood.

Consult Psychiatrist for it. It can be treated by medication and psychotherapy.

: Sudden increase in Intracranial Pressure - It means sudden increase in pressure in brain. It occurs due to brain tumor bleed/brain tumor edema. It is uncommon but must be ruled out. It usually presents as sudden headache, vomiting, visual blurring, followed by fall.

Consult neurologist and he will examine her, advise MRI brain to rule it out. Tumor is different from others as it usually needs surgical management.

: Dehydration and electrolyte imbalance - If the attack occurred after exercise and she had sweat a lot. It could be plain dehydration and loss of electrolytes/glucose. It can be suspected more if temperature was high, there was sweating.
It responds to fluid intake, taking lemon-salt-sugar water. There is no amnesia, urinary incontinence.

The eczema flared up due to sudden increase in stress or exposure to allergen during fall. I have given you a list of diagnosis, so that you can correlate her features and consult accordingly. Do not ignore it. If you have any investigation report/any more details, do let me know. It would help in narrowing her diagnosis.

Hope it will help you. Thanks. Take care.

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