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Spells: in search of a cause
1Division of Hypertension, Mayo Clinic Rochester, Minnesota 55905, USA.
Mayo Clinic Proceedings
|August 1, 1995
Summary
Spells are recurrent, self-limited episodes with diverse causes. A systematic diagnostic approach, guided by history and physical exam, is crucial for identifying the underlying condition.
Area of Science:
- Clinical Medicine
- Diagnostic Neurology
- Symptomatology
Background:
- Spells are characterized by sudden onset, stereotypic, self-limited, and recurrent symptoms.
- These episodes involve both subjective patient perceptions and objective clinical findings.
Observation:
- A systematic approach is essential for diagnosing the cause of spells.
- Potential causes span endocrine, cardiovascular, psychologic, pharmacologic, and neurologic disorders.
Findings:
- Initial assessment relies on comprehensive history, physical examination, and basic laboratory studies.
- Specialized testing is guided by clinical suspicion and the specific spell phenotype, including associated facial flushing or pallor.
Implications:
- Clinicians should consider a broad differential diagnosis for patients presenting with spells.
- Diagnostic strategies should be tailored based on historical and physical examination findings to efficiently identify underlying causes.