Differential diagnosis - 5MF

• Metabolic
• Microbes
• Migraine - acute confusional migraines
• Mischief - SOL, hydrocephalus, bleed, venous sinus thrombosis
• Medications
• Fits

History

• Presence of fever, vomitting and/or headache
• was the decrease in consciousness suddenn, fluctuant or gradual
• any history of trauma?
• What medications may the child have had?
• Family Hx - any unexpected deaths?

Investigations

• Glucose levels
• blood gas
• ketones
• FBC, U and E, Ca