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What Causes Sudden Onset Of Severe Headache, Nausea, Disorientation And Slurred Speech?

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Posted on Fri, 22 May 2015
Question: Male, 76 y.o., hx of Type 2 diabetes, HTN, High cholesterol, sudden onset Severe headache pain 9/10 with nausea and vomiting, disorientation, unable to sit still, weak, speech is slurred sporadically. CT Scan, MRI and Spinal Tap are negative. CBC is normal, with exception of elevated protein. No fever, blood pressure is normal Glucose measures 147 on day 2 without food or much hydration. What would you diagnose? Hospital says most likely Trans Global Amnesia but symptoms do not match definition.
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Answered by Dr. Saumya Mittal (51 minutes later)
Brief Answer:
possible electrolyte imbalance

Detailed Answer:
Hi
I am Dr Mittal.
I have read your query. I think I would be able to help you.

The symptoms of the query are quite suggestive of a possible Bleeding inside the skull. Looking at the query that would be my first thought. However, the scans are normal. I would suggest repeating a ct scan again for late development of the features.

The other possibility is that the patient could have a dyselectrolytemia, specially sodium. I would suggest checking That. Almost all features except headache are explained by it. And frankly there are case reports for headache as well.

I therefore suggest the same to you.
I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Saumya Mittal

Diabetologist

Practicing since :2004

Answered : 2897 Questions

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What Causes Sudden Onset Of Severe Headache, Nausea, Disorientation And Slurred Speech?

Brief Answer: possible electrolyte imbalance Detailed Answer: Hi I am Dr Mittal. I have read your query. I think I would be able to help you. The symptoms of the query are quite suggestive of a possible Bleeding inside the skull. Looking at the query that would be my first thought. However, the scans are normal. I would suggest repeating a ct scan again for late development of the features. The other possibility is that the patient could have a dyselectrolytemia, specially sodium. I would suggest checking That. Almost all features except headache are explained by it. And frankly there are case reports for headache as well. I therefore suggest the same to you. I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.