seizures under evaluation!

CHIEF COMPLAINTS -

30year old female complaints of involuntary movements 7-8 days back.

HOPI-

Patient was apparently normal till 7years back, then she amotionally traumatized and physically assaulted by her husband who bet her on the neck following which she had loss of consciousness then she was taken to near by hospital where she had 2 episodes of vomitings. CT scan then showed some lesion in brain and adviced MRI brain and got it done at KIMS-NKP and treated with some medication for month then stopped.

Now 7-8 days back patient had emotional conversation with husband and sister-in-laws and was weeping following which she suddenly became light headed and fell down with involuntary movements of both upperlimbs and lowerlimbs with uprolling of eyes with 1 hour of post ictal confusion. Then she became unconscious for breif period and was taken to local hospital from their refered to higher center, since then she felt weakness of right upperlimb and lower limb with tingling sensation.

H/o 4 medical termination of pregnancy(medical),

1 MTP (surgical/evacuation in 4th month) 

PAST HISTORYN/k/c/o HTN, DM

TREATMENT HISTORY: Was on OCP's.

PERSONAL HISTORY: she is a married women, worked as a clerk and stopped working since 7years due to weakness.

Non vegetarian, 

Bowel and bladder movements -regular

Micturition-normal,

No known allergies

No addictions

FAMILY HISTORY: No H/o DM, HTN, heart disease,stroke,TB, asthma or any psychiatric illness.

GENERAL EXAMINATION:

No pallor, icterus, cyanosis, clubbing, lymphadenopathy, oedema, malnutrition

Vitals-. Temp: afebrile 

PR- 80/Min    

RR- 18/Min

BP- 110/80 mmHg

Spo2 -98%at RA

SYSTEMIC EXAMINATION

CVS- No thrills, S1  S2 heard, no murmurs

RS- no dyspnea, wheeze, position of trachea -central, breath sounds-vesicular

P/A - Obese, non tender

CNS- Pt is C/C/C, speech normal, no signs of meningeal irritation

Tone of both upper and lower limbs- normal

Power of R UL-5/5.      L UL-5/5

Power of L UL -4/5.      R UL- 5/5

REFLEXES- 

           B.   T.      S.     K.    A

R.       +3.  +3.   +3.   +3.   +3

L.        +3.  +3.   +3.    +3.   +2

INVESTIGATIONS:

Hb- 10.4.    Tlc- 12000.    Plt- 3.69

LFT:

TB- 0.71    DB- 0.16.    AST/ALT - 14/13

ALP-151.   TP- 6.7.   Alb- 4.2

U-15.    S.Cr- 0.8.   Na+148.  K+ 3.8.   Cl-107

PROVISIONAL DIAGNOSIS - Seizures under evaluation.