ABSTRACT
Your exploration of the history will reveal that Simon is a newly diagnosed diabetic and has been commenced on insulin treatment by his general practitioner (GP). His medical history is otherwise unremarkable; he has been well recently and he denies any previous history of fitting. He reveals to you that his friends noticed him to be irritable, pale and sweaty prior to trembling and then fitting. He remembers feeling light-headed and a bit faint prior to the fit. He denies tongue biting, loss of consciousness and urinary/faecal incontinence. The examiner will reveal to you that his physical examination is entirely unremarkable. Your interpretation should be that this episode of fitting is most likely to be a presentation of hypoglycaemia, knowing that you will not have been given a history of diabetes if it was not relevant, and hence your management plan is along these lines.
