Reference no: EM133713973

Question

A middle-aged man is transported to the emergency department unconscious and accompanied by a nurse from the medical floor. The nurse states that the patient was in line in front of her in the hospital cafeteria when he suddenly fell to the floor. He then had a "generalized tonic-clonic seizure." She called for assistance and accompanied him to the emergency department. No other historical information is available. On physical examination, the patient is confused and unresponsive to commands. He is breathing adequately and has oxygen in place via nasal prongs. His vital signs are as follows: temperature, 38°C; blood pressure, 170/90 mm Hg; heart rate, 105 bpm; respiratory rate, 18/min. Oxygen saturation is 99% on 2 L of oxygen. Neurologic examination is notable for reactive pupils of 3 mm, intact gag reflex, decreased movement of the left side of the body, and Babinski reflexes bilaterally. Examination is otherwise unremarkable.