20 year old female with involuntary movements of both upper and lower limbs. ?GCTS

 Unit 5 : case admissionon date :5/2/2021

Dr. Natasha mam( Pg Y3) 

Dr. Zain alam Pg Y2) 

Dr. Sashi kala ( Pg Y1)

Dr. Shailesh Patil( Pg Y1) 

Sridevi ( Intern) 

Anjali Vishwas (intern)

Shriya reddy(intern)

Mourya(intern)

A 21 year old female, presented to

casualty with            involuntary movement s of both upper and lower limbs since 5  pm today, 5 episodes, each episode lasting for 2- 3 minutes, GTCS pattern, associated with uprolling of eyes present, not associated with tongue bite,    involuntary micturition, defecation, post ictal  confusion, drowsiness, confusion

C/0 headache, since yesterday, which is sudden in onset, gradually progressive, throbbing type of pain, not associated with nausea, vomitings, diminished vision.

No c/0 fever, shortness of breath, palpitations,          giddiness, chest pain, pedal edema, burning micturition


Not a known complainpast history of HTN, DM,  Epilepsy,asthma, Thyroid abnormalities, cVs and cns  abnormalities

No similar complaints in the past

Vitals at the time of presentation:


BP: 140/80 MM HG

PR: 115 bpm



RR: 22 cpm

Temp: Afebrile

Spo2: 100 percent RA

On examination:

CNS examination:

Patient is drowsy but arousable, speech is normal, no signs of meningeal irritation, cranial nerves examination intact, sensory,motor system is normal, reflexes normal, no cerebellar signs

CVS examination: S1 S2 heard

Per abdomen:NAD

Respiratory system:Bae+, NvBS

Diagnosis: GTCS? Seizures under evaluation

Rx:

Inj. Levipil 500 mg IV/BD

Inj. Optineuron 1 amp in 100 ml NS/IV/OD

Inj. Pantop 40 mg IV/OD

Bp, PR, SPO2 monitoring 6 th hourly

Temp monitoring 4 th hourly.

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