I felt like Dr. House in clinic today. Bear with me. [View all]

[Aristus]

I have a patient who has been experiencing fainting episodes for about 18 months. The VA is convinced it is due to injuries the patient sustained sixteen years before the symptoms presented. Doesn't make a lot of sense. A prior report by a neurologist states the evidence obtained from CT imaging doesn't correspond to the clinical symptoms.

I've looked everything over, and the other day, I had a brainstorm: has he ever been evaluated for narcolepsy? Today, I obtained a new history from the patient, trying to suss out if he has risk factors for narcolepsy. I've started a workup for that diagnosis. If my diagnosis is correct, we can start treating him. If I'm wrong, at least we've ruled another condition out. My patient was happy that at least someone is exerting a little brain-power on the problem...