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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

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