Recurrent Confusion and Seizures in an Adult Male

Qing Meng, MD, PhD; Gillian Luxton, MD, FCACB


Lab Med. 2004;35(8) 

In This Article


49-year-old male.

Recurrent confusion and seizures with violent behavior.

For the last 10 years, the patient had recurrent difficulty with early morning spells of confusion. Recently, this symptom became worse, with violent behavior and seizures, and he was sometimes incontinent of stool and urine. He indicated, however, that he felt better after eating snacks or breakfast, particularly if they included orange juice. He denied any problems with palpitations, diaphoresis, tremor, or paralysis. He had no nausea, vomiting, headache, or vision change.

Six months previously, he presented with low back pain and was diagnosed with seminoma and a large retroperitoneal/periaortic encasing mass with residual tumor and received chemotherapy. He had no history of diabetes mellitus, alcoholism, drug addiction, heart disease, hypertension, or epilepsy.

No family history of diabetes mellitus, stroke, seizure, or alcoholism.

The patient denied drug abuse and taking any medications.

Vital signs were: BP, 120/70 mmHg; HR, 86/min. He was conscious but appeared anxious. There were no remarkable findings on review of cardiovascular and respiratory systems. Liver and spleen were not palpable. The movement and strength were normal for both arms and legs.

Table 1 and Table 2 .


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.