STATUS EPILEPTICUS(RESOLVED) SECONDARY TO OLD INFRACT IN RT PARIETAL AND TEMPORARY REGIONS K/C/O HTN SINCE 2 YEARS CVA 1 YR AGO POST EXTUBATION
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63YR OLD MALE CHIEF COMPLAINTS OF INVOLUNTARY MOVEMENTS IN LEFT UPPER LIMB AND LOWER LIMB SINCE 2 YEARS
HOPI:
PATIENT WAS APPARENTLY ASYMPTOMATIC TILL 2 YEARS AGO,HE THEN DEVELOPED INVOLUNTARY MOVEMENTS SUDDEN IN ONSET ,STARTED WITH INITIAL CRAMPS,INNVOLUNTARY MOVEMENTS.LASTED FOR 10 MINS FOLLOWED BY POST ICTAL CONFUSION.INVOLUNTARY MOVEMENTS STARTS AGAIN AFTER 30 MINS AND LASTED FOR 1 HR,ASSOCIATED WITH DROOLING OF SALIVA,UPROLLING OF EYEBALL,INVOLUNTARY MICTURITION.
NO H/O FEVER,COUGH,VOMITING,LOOSE STOOLS,PAIN ABDOMEN,GIDDINESS.
N/H/O WEAKNESS IN RT UPPER LIMB AND LOWER LIMB,BLURRING OFVISION.
PAST HISTORY:
K/C/O HTN 2 YEARS ON TAB CINOD 10 MG PO/OD
CVA LT HEMIPARESIS 1YR AGO ON TAB.ECOSPIN AV 150/20 PO/OD
GENERAL EXAMINATION
PT IS C/C/C
NO SIGNS PALLOR, ICTERUS,CYANOSIS,CLUBBING,
TEMP 96.8 F
PR 122 BPM
RR 24 CPM
BP 120/80 MM HG
SPO2 98 @ RA
GRBS 103 MG/DL
TREATMENT HISTORY- 2YRS ON TAB CINOD 10 MG PO/OD
PERSONAL HISTORY
ALCHOL-STOPPED USAGE 1.5 YEARS AGO
CVS S1 S2 HEARD
RS BAE +
GIT SOFT NT
CNS LEVEL OF CONSCIOUSNESS - STUPOROUS
SPEECH NO RESPONSE
NO MENINGEAL SINGS
CRANIAL CANNOT BE ELICITED
MOTOR SYSTEM
TONE RT LT
UL N N
LL N N
POWER UL AND LL - CANNOT BE ELICITED
SENSORY SYSTEM-CANNOT BE ELICITED
GLASGOW SCALE- E2 V1 M2
INVESTIGATION:
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DIAGNOSIS:
STATUS EPILEPTICUS(RESOLVED) SECONDARY TO OLD INFRACT IN RT PARIETAL AND TEMPORARY REGIONS
K/C/O HTN SINCE 2 YEARS CVA 1 YR AGO
POST EXTUBATION
TREATMENT:
NEB IPRAVET 6TH HRLY
NEB.BUDECORT 12TH HRLY
TAB.AMOXYCLAV 625MG PO/BD
TAB.METROGYL 400 400 MG PO/TID
TAB.LEVIPIL 500 MG PO/TID
TAB.SODIUM VALPROATE 500 MG PO/BD
TAB.PAN 40 MG PO/OD/BBF
INJ.LORAZEPAM 2CC/IV/STAT IF SEIZURE ACTIVITY)
TAB.ECOSPRINE AV 75/20 MG PO/HS
TAB.STROCIT PLUS 800/500 MG PO/OD
TAB.CINOD 10 MG PO/OD
ADVICE AT DISCHARGE:
TAB.LEVIPIL 500 MG PO/TID 8AM-2PM-8PM
TAB.SODIUM VALPROATE 500 MG PO/BD 8AM - 8PM
TAB.PAN 40 MG PO/OD/BBF 7AM
TAB.ECOSPRINE AV 75/20 MG PO/HS 8PM
TAB.STROCIT PLUS 800/500 MG PO/OD 8AM
TAB.CINOD 10 MG PO/OD 8AM
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