356) A 7 year old boy is evaluated in your office for frequent episodes of “staring spells” while at school. His teacher reports that he does not seem to concentrate during the class and stares blankly in to space. He has had many such episodes in the past six months that got his teacher very concerned. Waving a hand in front of his eyes and calling out his name does not seem to disrupt these episodes. Often he returns to his norm when the boy next to him physically moves him or tickles him. He is otherwise, healthy and plays well with other kids without any issues. His mother also has noticed such episodes while he was watching television at home. On examination, he appears comfortable and healthy. There are no physical abnormalities. He is attentive to your questions and does not seem to be distracted. Which of the following is the most appropriate next step?
A) Re-assurance
B) Obtain Electro-Encephalogram
C) Refer to Child Psychiatry
D) Start Methylphenidate trial
E) Refer to Neurology
Archer USMLE Step 3 and Internal medicine blogs are the products of highly successful Archer USMLE reviews. These blogs are run by board-certified teaching physicians. From time to time, several evidence based guidelines on disease management strategies and patient care will be posted and discussed here to help USMLE Step 3 examinees and those appearing for Internal Medicine Boards. These include the areas of medicine that are highly tested on USMLE 3 as well as Internal medicine board exams.