Patient lying unconscious since night.CT head and all other investigations normal.Kindly suggest d/d and treatment plan.Thanks.



Respected seniors and colleagues there's nothing to be upset.By saying that everything is normal , I tried to sum up.And that's what exactly is. Blinking movements of the eyes is what made me suspicious and that I wanted to show in the vedio. Patient was feigning unconsciousness.I just stood by his side and told his relative loudly that he will have to be shifted to the Operation theatre, and within next ten minutes he was talking. Thanks all.Thanks Dr.Naveen.R and Bhargavi Jakku.

In my setup v try putting ryles tube !

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Normal CT head is noted. & All other investigations normal noted. Note that no involuntary movements, normal reflexes, & response to Pain. ABG with electrolytes, glucose, lactate, hb.( Maybe normal lft, RFT) CXR, ECG , Echo (sos), MRI brain (sos) Alcohol breath level and blood level Drugs level . Narcan ( naloxone) for opioids . Flumazenil for benzodiazepines. Observation and monitoring. Maintain ABCDE and Vitals. Need to wait and watch. Need further evaluation Rx.

+ EEG,

What is RBS ANY history of fever headache ?? Neck rigidity?? Plantar teflex?? Tone? Power? Deep tendon reflexes? Light reflex?? Electrolytes?? Any history of convulsions?? Blood pressure and pulse?? urine output??

Video shows rapid eye movt with closed lids, dd pt is in rem sleep or feigning ...eeg waves will tell if pt is awake or asleep or any other abn Other metabolic causes n external wounds ruled out? Any snake bite marks ? What about pupils n response to attempted rules tube insertion, any iv drug use marks ?

Dr. Pl.mention his vitals prior put a case. D/D any h/o convulsion, fever,is pt. Is diabetic? Pl. Do his abg s. Ammonia,bsl. Any h/o fever.

Check pupillary reacn,plantters, neck rigidity,kernigs sign ,if aal are normal ,then hysteric

Thanks sir

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Yes sir, that's being done at many places s.Thanks

May b a case of snake bite..'kalach bite' may drowsy

Thanks sir

Its a case of alcohol overdose.

Attach his CT/MRI reports,Blood investigations,sugar status,to lead any differential.

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