Disorientation, Confusion II

Abstract

44-year-old man was reviewed in the neurology outpatient clinic for solitary episode of loss of awareness, possibly consciousness. He had had a very busy day and came back home at around 5 pm. There was an argument in the house which involved his daughter (teenager) and his partner. Surprisingly his daughter developed chest pain during the argument so they got into the car and patient started to drive her to hospital. However when they were still close to home, the patient suddenly stopped responding, but he tightly gripped the steering wheel. The episode lasted between 5 and 10 seconds and led to a low speed road traffic accident (he hit a sign post, airbag was not deployed). According to his partner it seemed that he moved the wheel slightly to the side to avoid a car going opposite direction so it seemed that he did not lose complete control of his actions. The patient mentioned during examination that he could hear what other people were telling him/saying and that “people were screaming in the car”. He was not “himself” and was quite vacant and confused after the accident for 5–10 minutes. His partner said that he was “different” for the rest of the day. Objective neurological findings were normal. He credited this episode to stress and the argument.