Each of these associated symptoms and findings suggests serious disease and should be evaluated before going ahead with this protocol.

• Altered mental status suggests Wernicke’s encephalopathy, stroke, encephalitis, seizure, intoxication with alcohol, illicit drugs, or carbon monoxide, or hypertensive encephalopathy.
• Transient loss of consciousness suggests arrhythmia, acute coronary syndrome, aortic dissection, pulmonary embolism, vasovagal syncope, hypovolemia, stroke, subarachnoid hemorrhage, or seizure.
• Headache suggests stroke, craniocervical vascular dissection, meningitis, carbon monoxide exposure, vestibular migraine, high or low intracranial pressure, or subarachnoid hemorrhage.
• Neck pain suggests craniocervical vascular dissection, especially of the vertebral artery.
• Chest and/or back pain suggests acute coronary syndrome or aortic dissection.
• Abdominal and/or back pain suggests ruptured ectopic pregnancy or aortic dissection.
• Dyspnea suggests pulmonary embolism, pneumonia, or anemia.
• Diplopia suggests a neurological condition, such as myasthenia gravis or multiple sclerosis, or hyperthyroidism or stroke.
• Dysarthria suggests stroke, brain injury, brain tumors, Parkinson’s disease, amyotrophic lateral sclerosis, Huntington’s disease, multiple sclerosis, cerebral palsy, or muscular dystrophy.
• Dysphagia suggests stroke, head injury, multiple sclerosis, or dementia.
• Dysphonia suggests malignant tumors of the larynx, multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis or myasthenia gravis.
• Dysesthesia suggests multiple sclerosis, diabetes mellitus, or thalamic infarct.
• Drop attacks suggest brainstem ischemia.
• Tilt or inversion illusion suggest brainstem ischemia.
• Bleeding or fluid loss suggests hypovolemia or anemia.
• Fever or chills suggests systemic infection, encephalitis, mastoiditis, or meningitis.
• Anisocoria suggests Horner syndrome.
• Abnormal glucose suggests symptomatic hypoglycemia or diabetic ketoacidosis.