50/M with seizures under evaluation

 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 box is welcome.


Interns:

Dr Archana

Dr Jeeharika

Dr Sreeja

Dr Harsha

Dr Kalyan


Dr Raveen PGY1

Dr Aashitha PGY2

Dr Aravind PGY3

Dr Vamshi PGY3

Dr Hareen SR

Dr Praveen Naik Ass Prof

DR. RAKESH BISWAS HOD


Here is a case i have seen:

Admission under unit 3 on 04/03/2021

50/F was brought to casualty with c/o:

Seizures (? GTCS) 3-4 episodes, starting around 6:00pm 


HOPI: 

Patient was apparently asymptomatic till yesterday evening, she had seizures (?GTCS) 3-4 episodes, yesterday evening. 

Each episode of seizure lasting for 1-2mins with

Post ictal confusion lasting for 30-40mins.

Uprolling of eye balls +

Frothing from mouth+

Urinary incontinence +

Tongue bite -


Past history:

No h/o DM /HTN /TB /Asthma /Epilepsy /thyroid abnormalities /CAD


Personal history : 

Diet - mixed

Appetite - normal 

Sleep - adequate 

Bowel and bladder movements - regular 

Takes toddy occasionally 

Not a smoker


Family history :

No significant family history 


Drug and allergic history :

No known drug and allergic history 



On examination : 

Patient is drowsy

Moderately build and nourished 

She has nodular lesions all over the body.

No pallor/icterus/cyanosis/clubbing/generalised lymphadenopathy/ pedal Edema 





Vitals : 

BP: 110/80mmhg

PR: 98bpm

RR: 18cpm

SPO2: 99% at RA

Afebrile to touch

GRBS : 195mg/dl


Systemic examination: 

CVS: s1,s2 heard, no murmurs 

RS: BAE present, crepts + in Right IMA and right IAA

P/A: soft, non - tender 

CNS: 








SEROLOGY - Negative 


Hb- 10.9 g%


MRI : 


DIAGNOSIS : 

Seizure under evaluation

Comments

Post a Comment

Popular posts from this blog

50/M with Progressive supranuclear palsy

Image
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 box is welcome. Interns: Dr Archana Dr Sreeja Dr Harsha  Dr Kalyan  Dr Sahithi  Dr Jeehariki Dr Raveen PGY1 Dr Aashitha PGY2 Dr Aravind PGY3 Dr Vamshi PGY3 Dr Hareen SR Dr Praveen Naik Ass Prof DR. RAKESH BISWAS HOD Here is a case i have seen: Admission under unit 3 on 03/02/2021 Introduction: Progressive supranuclear palsy (PSP) is a less well-known neurodegenerative brain condition which is sometimes misdiagnosed as Parkinson’s disease or Alzheimer’s. The presence of a vertical supr
Read more

Right sided hemiplegia

Image
  34yr old man , as a working driver presented  in swallowing since 5am   Weakness in Right UL and LL since 5am   Deviation of mouth to left since 5 am  Slurred speech since 6am .  Pt developed sudden onset of  difficulty in swallowing while he tried drinking water followed by he suddenly developed weakness of rt upper limb and rt lower limb .  His attendant later observed deviation of mouth towards left side and slurring of speech.  H/o ? 1episode of GTCS 3years back, the patients attendant says they were also told that he had a heart problem back then.   He has been an occasionally  alcoholic since 20years .  Not a known case of Htn ,Dm type2, Thyroid disorder,  Asthma.  No history of any past surgeries.  On examination  A well nourished and obese individual with no pallor, Icterus, clubbing, cyanosis or lymphadenopathy Though he had bilateral pitting type of pedal edema extending upto his knees His Abdominal girth measured around 96cms He had no neurocutaneous markers Spine is norma
Read more

60/M with ?CVA

Image
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 box is welcome. Interns: Dr Archana Dr Jeeharika Dr Sreeja Dr Harsha Dr Kalyan Dr Raveen PGY1 Dr Aashitha PGY2 Dr Aravind PGY3 Dr Vamshi PGY3 Dr Hareen SR Dr Praveen Naik Ass Prof DR. RAKESH BISWAS HOD Here is a case i have seen: Admission under unit 3 on 03/03/2021 60/M with  C/O : inability to speak since evening (around 6pm.) Deviation of angle of mouth to left side since evening (around 6pm) Patient was apparently alright till evening, suddenly he was unable to speak (?slurring) w
Read more