Differential Diagnosis for 13 y/o Male with Possible Seizure
- Single Most Likely Diagnosis
- Epilepsy or seizure disorder: The patient's presentation of shaking, lip smacking (which could be a sign of an aura or automatism), and repetitive questioning suggests a seizure or post-ictal state. The headache could be a post-ictal headache.
- Other Likely Diagnoses
- Migraine with aura: The headache and possible seizure-like activity (shaking) could be part of a migraine aura. However, the lip smacking and repetitive questioning are less typical.
- Anxiety or panic attack: The tachycardia and repetitive questioning could be indicative of an anxiety or panic attack, though the shaking and lip smacking are less common symptoms.
- Viral or bacterial meningitis: The headache and possible seizure could be signs of meningitis, especially if the patient has a fever or other signs of infection.
- Do Not Miss Diagnoses
- Intracranial hemorrhage or stroke: Although less likely, these conditions could present with sudden onset of headache, seizure, and altered mental status. They are medical emergencies that require immediate attention.
- Central nervous system (CNS) infection (e.g., encephalitis): Similar to meningitis, encephalitis could cause headache, seizure, and altered mental status, including repetitive questioning.
- Hypoglycemia: Low blood sugar can cause seizures, confusion, and tachycardia, making it a critical condition to rule out.
- Rare Diagnoses
- Autoimmune encephalitis: A rare condition that could cause seizures, altered mental status, and repetitive behaviors.
- Mitochondrial disorders: Certain mitochondrial disorders can cause seizures, headaches, and other neurological symptoms.
- Porphyria: A group of rare genetic disorders that can cause neurological symptoms, including seizures, headaches, and altered mental status.