Differential Diagnosis for a Man with Tonic Clonic Seizure When Furnace Exploded

• Single most likely diagnosis:
  • Hypoxic-Ischemic Encephalopathy: This condition occurs due to a lack of oxygen to the brain, which could happen if the furnace explosion led to a brief period of asphyxiation or if the patient was unconscious and not breathing properly. The seizure could be a manifestation of the brain's response to the hypoxic event.
• Other Likely diagnoses:
  • Traumatic Brain Injury (TBI): The physical force from the explosion could have caused a head injury leading to a seizure. Even if the patient did not have an obvious head wound, the force of the blast could have caused intracranial injuries.
  • Carbon Monoxide Poisoning: Furnace explosions can lead to the release of carbon monoxide, a colorless, odorless gas that can cause seizures among other symptoms if inhaled in significant quantities.
  • Post-Traumatic Seizure: The stress and physical trauma from the explosion could trigger a seizure in someone who may have a predisposition to seizure disorders.
• Do Not Miss diagnoses:
  • Meningitis: Although less likely, if the explosion involved a breach in the patient's skin or mucous membranes and introduced bacterial contaminants into the CNS, meningitis could be a life-threatening complication.
  • Intracranial Hemorrhage: Any form of head trauma from the explosion could lead to bleeding within the brain, which is a medical emergency.
• Rare diagnoses:
  • Epileptic Seizure Triggered by the Explosion: While the explosion itself is unlikely to cause new-onset epilepsy, it could potentially trigger a seizure in someone with a pre-existing seizure disorder.
  • Toxic Exposure: Depending on what was burned or released in the explosion, there could be exposure to toxic substances that could cause seizures, though this would be less common and dependent on the specific circumstances of the explosion.