Skip to main content

A 45 year old with seizures

This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs

A 45 year old  male chicken shop owner by occupation was brought  with c/o sudden onset of giddiness followed by LOC that was preceded by tonic UL movements f/b regain of consciousness at 4:30 pm on 18/5/22

HOPI-

Patient was apparently alright yesterday ,then developed 1 episode of sudden onset of giddiness f/b tonic movement of UL for 3 minutes f/b LOC for 15min . During period of LOC ,vertical uprolling of eyes +,tongue bite +,frothing+
H/o post ictal confusion for few seconds 
No h/o aura preceding the events 
No h/o involuntary micturition/defecation. 

Past history -
N/K/C/O HTN,DM,BA,EPILEPSY,TB,CAD,CVA
Personal history-
Appetite -normal
Diet-mixed
B&B -regular
Addictions -patient has been consuming alcohol  15 years  ago ,started occasionally which  then increased to daily intake  of 90ml
of whiskey since 3 years

General examination -
Pt is c/c/c
Bp-180/100mmhg
PR-128bpm
RR-18cpm
Grbs-248mg%

Systemic Examination-
CVS-S1,S2+
RS-BAE+,NVBS
P/A-soft,non tender
CNS-
HMF+
GCS-15/15
POWER
           RT LT
UL- 5/5 5/5
LL- 5/5 5/5
Reflexes-
        Rt               Lt
B       +                +
T       +                +
S        +                +
K         +                +
A         +                 +
P    dorsiflexion

Diagnosis-
New onset seizures secondary to
?alcohol withdrawal 
? Hypertensive urgency
Investigations-

MRI-No features suggestive of stroke
Small vessel is chemical changes seen 
(Final report awaited)
Treatment given-
1.TAB NICARDIA 10mg PO/STAT
2.INJ LEVIPIL 500mg IV/STAT
3.INJ OPTINEURON 1AMP IN 100ml NS IV /STAT

Treatment at discharge-

1.TAB LEVIPIL 500mg PO/BD
2.TAB THIAMINE 200mgPO/OD
3.TAB NEUROBION FORTE PO/OD
4.TAB RESTYL 0.5mg PO/OD 
5.TAB TELMA 20mg PO/OD @8AM
6.MUCOPAIN GEL FOR L/A
7.HOME BP MONITORING

Comments

Post a Comment

Popular posts from this blog

A 50 year old with sob,pedal edema

"This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment" A 50 year old female patient came to casuality with complaints of pedal edema since 3 months ,decreased urine output since 3 months ,shortness of breath since 3 days HOPI Patient was apparently asymptomatic 3 months back then developed fever -low grade not associated with chills Pedal edema 3 months ago Decreased urine output 3 months ago Sob -progressed to grade 4i Patient  was advised for hemodialysis but pt attendees were not willing Patient has been taking nsaids since past...
Post a Comment
Read more

38 year old female with diffuse headache and multiple joint pains

This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs A 38 year old female sales person by occupation came with complaints of  Diffuse headache since 1 year  Multiple joint pains since 1 year Lumbar-cervical-shoulder joint-knee joint-wrist-PIP DIP -spared   HOPI Patient was apparently asymptomatic 1 year back then developed headache -diffuse type,insidious in onset ,gradually progressive  Relieved on medication Multiple joint painsnot associated with early morning stiffness and fever.joint pains increases with work associated with neck pain Tingling of both upper limbs  Past history  K/C/O HTN -not on medication  N/K/C/O DM,BA,EPILEPSY, TB G...
Post a Comment
Read more

A case of 50 year old patient - fever with thrombocytopenia with NS1 antigen positive

"This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment" A 50 year old female housewife by occupation came with C/O fever since 7 days C/O headache since 7 days C/O body pains since 7 days HOPI- Patient was apparently asymptomatic 7 days back then developed  fever  associated with chills and rigors ,subsided on taking medications C/O headache -diffuse type,not associated with nausea ,vomiting since 7 days C/O body pains since 7 days Patient was taken to near by RMP and diagnosed with Dengue NS 1 antigen positive and treated conservat...
Post a Comment
Read more