A 10-Year-Old Boy With Fainting Spells and Seizure Activity

Shatha M. Khatib, MD

Disclosures

September 25, 2019

Physical Examination and Workup

Upon physical examination, the patient is a well-appearing and well-developed boy whose weight and height are in the 50th and 60th percentiles, respectively. His oral temperature is 98.6°F (37°C). His pulse is strong at 66 beats/min, with a regular rhythm. His blood pressure is 105/65 mm Hg, and his respiratory rate is 15 breaths/min.

Head and neck examination findings are normal. The lungs are clear to auscultation, and normal respiratory effort is noted. Cardiac auscultation reveals normal S1 and S2 heart sounds, and no audible murmurs, rubs, or gallops are heard. His abdomen is soft, with no tenderness. No organomegaly is detected. The neurologic examination reveals intact cranial nerves and intact speech. Sensory and motor functions are normal in all extremities, without any pronator drift. The deep tendon reflexes are brisk and symmetric throughout. The patient's Romberg sign is negative, and his gait is stable.

The laboratory analysis, including a complete blood cell count and a basic metabolic panel with serum electrolytes (including calcium and magnesium), is normal. Chest radiography and brain CT findings are also normal. An ECG is obtained (Figure 1).

Figure 1.

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