<human>: Husband is 62 w/o Caucasian male with DX. of Chronic Progressive MS x 17 years. Today he is very confused, says he can t distinguish reality from dreams. Has been sleeping very poorly for past several weeks due to severe muscle spasms in shoulders, legs. Medications; Low-dose Naltrexone, Tramadol (never together), Magnesium, Curcumin. This confusion is very about normal for him, and has lasted the entire day. He does know date/day of week/ current President, etc., no drooping of face, can stick out tongue, smile widely. TIA?
<bot>: Hello, But this is probably not due to TIA as it lasted the whole day. However it could be due undiagnosed diabetes, electrolyte imbalances and kidney dysfunction.  So I would recommend that he gets a blood test for blood glucose levels both fasting and postprandial, kidney functions test including urea and creatinine and blood gases test. Hope I have answered your query. Let me know if I can assist you further.  Take care 