Disorientation, Confusion I

Abstract

47-year-old woman presented with a 2 year history of recurrent events where she suddenly “did not known what she was doing”; for example having the remote control for the television in her hand and not knowing what to do with it. But within 1 minute she was able to use it again. Interestingly she also noticed that she had a funny feeling described as “something was going to happen before it had happened”, or that she can see something which has already happened. Another episode occurred while she was getting juice from the fridge. She couldn’t work out how to actually open and pour it into the glass which was sitting beside the carton of juice. These episodes can take place several times a day, although she can go for several weeks without obvious incidents. Her speech “sometimes went” as well and she could not express herself properly. She was not sure if her ability of understanding is preserved completely during these spells. When admitted she looked very anxious and agitated. Anxiety was blamed for her symptoms by her and family. On objective examination there was hyperreflexia in all four extremities and plantars were extensor/positive. Cranial nerves and cerebellar functions were normal. Otherwise no neurological pathology was found.