A 45 yrs old female pt with c/o 5-6 episodes of 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 box is welcome. 

CASE PRESENTATION:

A 45y old female patient who is homemaker by occupation came to casualty with c/o 

1.seizures since 2am(5-6 episodes)

Patient was apparently asyptomatic till 2am, then developed a seizure episode at 2am involving all the four limbs associated with frothing,uprolling of eyeballs,loss of speech,loss of consciousness.the episode lasted for less than a min .This episode was evidenced by her daughter who was sleeping beside her and they went to a local hospital where she regained her consciousness and they came back home.later at 2:45am she had 2nd similar episode and there were similar such 5 episodes in every 10 minutes without regain of consciousness and presented to casualty in the state of drowsiness in our hospital

H/o post ictal confusion 

No h/o tongue bite,involuntary micturition and defecation during episodes

No h/o head injury,warpaint,ear discharge

No h/o cold ,cough,headache,burning micturition,haematuria,loose stools

PAST HISTORY:No h/o similar complaints in the past 

Not k/c/o DM,HTN,asthma,CKD,CHD

HABITS: He was on mixed diet, appetite normal, constipation only on high protein diet 

Non alcoholic and nonsmoker

No other addictions 

GENERAL EXAMINATION: pt is conscious, coherent, cooperative and oriented to time, place and person

Pallor+

No h/o icterus,cyanosis,clubbing, lymphadenopathy,edema

VITALS:

Pt was a febrile on presentation 

BP:90/70mmhg

PULSE:94pm

RR:21cpm

Spo2:98% on RA

GRBS:184mg/dl

GCS:E2V1M4

B/l pupils reacting to light 

PER ABDOMEN:

Soft,diffuse tenderness+(more in epigastric and supra pubic region)

Bowel sounds +


CVS:s1 s2 heard, no murmurs

RS: BAE clear, normal vesicular breath sounds heard,no added sounds


CNS: higher mental functions: normal

        Cranial nerves: intact

       Motor system: intact

       Sensory system: intact

INVESTIGATIONS:

PROVISIONAL DIAGNOSIS: GTCS.



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