Neurologic illness patient history

In humans, the acute symptoms of ASP caused by domoic acid include vomiting, abdominal cramps, diarrhea, severe headache, and loss of short-term memory. In some cases, confusion, memory loss, disorientation, and even coma are reported. In addition, seizures and myoclonus are observed acutely. Permanent neurologic sequelae, especially cognitive dysfunction, were reportedly most likely in persons who developed neurologic illness within 48 h, males, in older patients (>60 years), and in younger persons with pre-existing illnesses such as diabetes, chronic renal disease, and hypertension with a history of transient ischemic attacks. The first human cases of ASP were identified after an outbreak in Prince Edward Island, Canada since then, there have been cases of ASP in marine mammals and birds in the Pacific Northwest of the United States and Canada. 

Pulmonary Does the patient require medications for pulmonary disease that may affect neurological functioning such as beta agonist-induced tremor Could a medication such as beta-blockers prescribed for essential tremor cause deterioration of pulmonary function Could an acute pulmonary illness such as pneumonia be contributing to delirium Does the patient have a history of pulmonary embolism that may indicate a predisposition to thromboembolic disorders Is the patient a current or past smoker, contributing to stroke risk or migraines ... 

Most GCSE develops in patients with no history of epilepsy however, a patient with preexisting epilepsy may experience GCSE as a result of acute anticonvulsant withdrawal, metabolic disorder or concurrent illness, or progression of neurologic disease. 

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