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Other Funny Turns

Last updated 6th March 2024

Clues to Migraine Without Headache

  1. Younger patient.
  2. Symptoms are focal and positive.
  3. Symptoms have slow onset over minutes & evolve or spread
  4. The commonest symptoms are either visual or sensory – typically in the face and/or arm.

Clues to Partial Epilepsy

  1. Symptoms are focal and positive.
  2. Symptoms usually have rapid onset over seconds and evolve or spread.
  3. May be negative motor symptoms afterwards eg Todd’s paralysis.
  4. Simple partial seizures – no alteration of consciousness.
  5. Complex partial seizures – some alteration of consciousness.

Clues to Narcolepsy Syndrome

  1. An intense desire to sleep at inappropriate moments.
  2. Often associated with cataplexy ie sudden loss of postural tone. May cause patient to fall or may only affect parts of body eg mouth suddenly falls open or arm falls limp by one side
  3. Cataplexy usually triggered by strong emotion such as anger or laughter, also by sadness or a particular piece of music. Often responds to Fluoxetine.

Other Causes Transient Limb Symptoms/Signs

  1. Hypoglycaemia.
  2. Epilepsy
  3. Somatisation
  4. Rarely multiple sclerosis (arbitrary duration >24hours).

Other Causes Transient Monocular Blindness

  1. Papilloedema.
  2. Glaucoma.
  3. Retinal haemorrhage.
  4. Retinal detachment.

NB May see cholesterol emboli in retinal vessels in TIA if you are lucky