Differential Diagnosis for Seizures and Withdrawal Symptoms
- Single most likely diagnosis
- A) Alprazolam: The patient's symptoms of generalized tonic-clonic seizures, confusion, diaphoresis, tremulousness, and hypertension are consistent with benzodiazepine withdrawal. Alprazolam is a commonly used benzodiazepine, and its withdrawal is known to cause severe symptoms, including seizures.
- Other Likely diagnoses
- B) Cocaine: Cocaine withdrawal can cause seizures, but it is less likely than benzodiazepine withdrawal. Cocaine withdrawal typically presents with symptoms such as depression, anxiety, and fatigue, rather than the severe autonomic instability seen in this patient.
- C) Ecstasy (3,4-methylenedioxymethamphetamine): Ecstasy withdrawal can cause seizures, but it is less common than benzodiazepine withdrawal. Ecstasy withdrawal typically presents with symptoms such as depression, anxiety, and insomnia.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- D) Heroin: Heroin withdrawal can cause seizures, although it is less common. However, heroin withdrawal can be life-threatening if not recognized and treated promptly. The patient's symptoms of hypertension, tachycardia, and fever could be consistent with heroin withdrawal.
- E) PCP (phencyclidine): PCP withdrawal can cause seizures, although it is rare. PCP withdrawal can be life-threatening if not recognized and treated promptly. The patient's symptoms of confusion, agitation, and hypertension could be consistent with PCP withdrawal.
- Rare diagnoses
- F) Toluene: Toluene withdrawal can cause seizures, but it is extremely rare. Toluene is a solvent found in glue, paint, and other household products, and its withdrawal is typically seen in individuals who abuse these substances. The patient's symptoms do not strongly suggest toluene withdrawal, making it a less likely diagnosis.