Spells: in search of a cause.

William Francis Young, D. E. Maddox

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

OBJECTIVE: To determine the cause of spells, present clinical features, and discuss diagnostic approaches. DESIGN: Relevant medical literature is reviewed, and three illustrative cases are presented. RESULTS: Spells are a sudden onset of a symptom or symptoms that are stereotypic, self-limited, and recurrent. A spell involves both subjective perceptions and objective findings. In the assessment of patients who have spells, use of a systematic approach is important in determining the cause. The causes of spells include endocrine, cardiovascular, psychologic, pharmacologic, neurologic, and other miscellaneous disorders. A comprehensive history, physical examination, and basic laboratory studies are important in the initial assessment. Specialized testing is usually needed and directed by clinical suspicion based on the spell "phenotype" (for example, a pheochromocytoma, carcinoid syndrome, or mast cell disease) and the type of facial flush or pallor. CONCLUSION: In the assessment of the patient who has spells, the clinician should cast a wide but defensible diagnostic net. Initial studies should be directed by the clues obtained from the history and physical examination.

Original languageEnglish (US)
Pages (from-to)757-765
Number of pages9
JournalMayo Clinic Proceedings
Volume70
Issue number8
StatePublished - Aug 1995

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Physical Examination
History
Mastocytosis
Pallor
Carcinoid Tumor
Pheochromocytoma
Nervous System
Phenotype

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Young, W. F., & Maddox, D. E. (1995). Spells: in search of a cause. Mayo Clinic Proceedings, 70(8), 757-765.

Spells : in search of a cause. / Young, William Francis; Maddox, D. E.

In: Mayo Clinic Proceedings, Vol. 70, No. 8, 08.1995, p. 757-765.

Research output: Contribution to journalArticle

Young, WF & Maddox, DE 1995, 'Spells: in search of a cause.', Mayo Clinic Proceedings, vol. 70, no. 8, pp. 757-765.
Young, William Francis ; Maddox, D. E. / Spells : in search of a cause. In: Mayo Clinic Proceedings. 1995 ; Vol. 70, No. 8. pp. 757-765.
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