20 year old female with involuntary movements of both upperlimb and lower limb, ?GTCS

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 Unit 5 : Case admission date :05/02/2021

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, vomiting's, diminished vision

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

Not a known complain past 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.

T BACT OINTMENT FOR LOCAL APPLICATION. 

Investigations 

Chest x-ray 

MRI brain

Hemogram

LFT

RFT

ECG















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