54 yr old male pt with status epilepticus,Hypokalemia,hypoproteinemia,diabeties with microvascular complications
54 yr old male pt came with
Complaints of fever from 6 days
Complaints of seizure from yesterday
Patient was apparently asymptomatic 6 days back then he developed a fever for 2 days which was low grade ,intermittent and associated with chills and relieved on medication, patient was normal up to 2 days till Monday night then he developed involuntary movements of upper and lower limb and associated with tongue bite . patient was taken to private hospital [up To 8 episodes] of seizures happened till next day morning, then patient was taken to government hospital where CT was done then he had 5 more episodes of seizures within 2 days and was referred to KIMS for the furture evaluation
K/c/o DM since 15 yrs and on TAB.METFORMIN 500MG and TAB GLIMIPIRIDE
K/c/o HTN since 3 yrs and on medication TAB.ATENOLOL 50MG
Alcohol occasionally
somker [stopped 20yrs back]
O/E
Temp-afebril
PR-79bpm
BP-130/90 mmHg
spo2-97%at room air
GRBS-335 mg/dl
Systemic Examination
cvs-s1,s2+
Rs-BAE+
p/A-soft non tender
Complaints of fever from 6 days
Complaints of seizure from yesterday
Patient was apparently asymptomatic 6 days back then he developed a fever for 2 days which was low grade ,intermittent and associated with chills and relieved on medication, patient was normal up to 2 days till Monday night then he developed involuntary movements of upper and lower limb and associated with tongue bite . patient was taken to private hospital [up To 8 episodes] of seizures happened till next day morning, then patient was taken to government hospital where CT was done then he had 5 more episodes of seizures within 2 days and was referred to KIMS for the furture evaluation
K/c/o DM since 15 yrs and on TAB.METFORMIN 500MG and TAB GLIMIPIRIDE
K/c/o HTN since 3 yrs and on medication TAB.ATENOLOL 50MG
Alcohol occasionally
somker [stopped 20yrs back]
O/E
pt is conscious coherent cooperative
Temp-afebril
PR-79bpm
BP-130/90 mmHg
spo2-97%at room air
GRBS-335 mg/dl
Systemic Examination
cvs-s1,s2+
Rs-BAE+
p/A-soft non tender
GCS:-EV5M5
-CVS
Higher Mental functions-Normal
Cranial nerves-NAD
motor system-. R. L.
power UL-. 5/5. 5/5.
LL-. 4/5. 4/5.
Tone-. UL-. normal normal
LL-. normal normal
reflexes-. R. L.
biceps-. 1+. 1+.
triceps-. 1+ 1+
supinator-. 1+ 1+
knee. 1+ 1+
ankle-. 1+ 1+
plantar - flexion flexion
sensory system- intact
Cerebellar functions test
finger nose test normal
knee heal test -normal
gait