65 years old male patient with involuntary movements and focal seizures
65 year old male patient with involuntary movements and focal seizures
January 19,2023
65 year old male patient with Involuntary movements and focal seizures
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"Date of Admission- 19/01/2023
A _65_ year old male patient presented brought to casuality by his attenders with chief complaints of Involuntary movements of left upper limb and lower limb (4:00 pm)
HISTORY OF PRESENT ILLNESS
Patient was apparently asymptomatic till 1:00 pm.
Then he had fever episode which is relieved on medication ( dolo 650)
Then he developed Involuntary movements of left upper limb and lower limb and associated with uprolling of eyeballs , tongue bite
Involuntary micturition in clothes
No regain of consciousness between the episodes
Froathing
HISTORY OF PAST ILLNESS
H/o similar complaints in the past
13/3/2022:- seizures
Irregular medication of levipil
18/4/2022:- focal seizures secondary to hyperglycemia
First admission was found to having high GRBS, followed by which he developed Involuntary movements upper limb and lower limb
Old CVA 2 years back
Diabetic milletus:- 6 years - on medication ( insulin)
Hypertension:- 3 years - on medication
PERSONAL HISTORY
Occupation:. Farmer
appetite : normal
Diet : mixed
Marital status : married
Bowel movement : regular
Micturition: normal
FAMILY HISTORY
No relevant family history
GENRAL EXAMINATION
Patient is conscious, coherent, co-operative.
There are no signs of icterus, clubbing, pallor, cynosis, lymphadenopathy and edema
VITALS
SYSTEMIC EXAMINATION:
Cardiovascular System
Thrills- no
Cardiac sounds- S1, S2 +
Cardiac murmurs - No
RESPIRATORY SYSTEM
Position of trachea- central
Breath sounds- vesicular
No Dyspnea and wheeze
ABDOMEN
Shape of abdomen- scaphoid
tenderness - no
Palpable mass- no
Free fluid- no
Bruits- no
Liver- Not palpable
Spleen- Not palpable
Bowel sound- Yes
CENTRAL NERVOUS SYSTEM
Patient is drowsy
Speech- normal
Tone:
Cerebrilar signs :- finger and nose in cordination -- no
Knee and heel in coordination -- no
Examination of head and neck :- neck stiffened
Investigation
ECG:
TREATMENT
Phenytoin
Levipil
Sodium valproate
Aspirin
Pantaprazole
Dolo (650)
Levetiracetem
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