seizures under evaluation
18yr old female with abdominal pain since 4 days
Pt presented to the casualty with complaints of
Vomitings and loose stools since 10 days
Abdominal pain since 4 days
Generalised weakness and giddiness since 1 day
Involuntary movements in B/L upper and lower limbs this morning around 2:30 a.m
HISTORY OF PRESENTING ILLNESS:
Pt was apparently asymptomatic 10 days back, then she developed vomitings - 6-8 episodes /day,within 2 hrs of eating food,non bilious,non projectile ,not blood stained
Loose stools since 10 days- 3-4 episodes/day,watery,large volumes, non blood stained, subsided after 5 days.
Abdominal pain since 4 days which was initially localised to lower abdomen but then progressed to be diffused abdominal pain and non radiating
Generalised weakness and giddiness since 1 day.
Pt was taken to local hospital 1 day back,where she had one episode of seizure (B/L UL nd LL)?GTCS associated with drooling of salive,uprolling of eyeballs,involuntary micturition lasted for 2 mins .following that pt was in a state of comfusion(not able to identify the family members)
Pt was given inj.midaz 2cc and inj.levipil 500mg IV/stat and referred to our hospital for further evaluation and management
No h/o fever,headache,cough,cold
No H/o outside food consumption
PAST HISTORY:
No similar complaints in the past
H/O typhoid fever 4 months back
Not a k/c/o HTN,dm,asthma,TB,epilepsy,thyroid disorders
HISTORY OF PRESENTING ILLNESS:
Pt was apparently asymptomatic 10 days back, then she developed vomitings - 6-8 episodes /day,within 2 hrs of eating food,non bilious,non projectile ,not blood stained
Loose stools since 10 days- 3-4 episodes/day,watery,large volumes, non blood stained, subsided after 5 days.
Abdominal pain since 4 days which was initially localised to lower abdomen but then progressed to be diffused abdominal pain and non radiating
Generalised weakness and giddiness since 1 day.
Pt was taken to local hospital 1 day back,where she had one episode of seizure (B/L UL nd LL)?GTCS associated with drooling of salive,uprolling of eyeballs,involuntary micturition lasted for 2 mins .following that pt was in a state of comfusion(not able to identify the family members)
Pt was given inj.midaz 2cc and inj.levipil 500mg IV/stat and referred to our hospital for further evaluation and management
No h/o fever,headache,cough,cold
No H/o outside food consumption
PAST HISTORY:
No similar complaints in the past
H/O typhoid fever 4 months back
Not a k/c/o HTN,dm,asthma,TB,epilepsy,thyroid disorders
MENSTRUAL HISTORY:
Attained menarche at 12yrs of age
Since then she has regular cycles for every 30 days,With normal flow for about 4 days associated with pain but no clots .
PERSONAL HISTORY:
Diet-mixed
Appetite:normal
Bladder movements -regular
Bowel: loose stools 10 days back(4-5 ep/day) subsided 5 days back
Addictions-nil
Sleep -adequate
FAMILY HISTORY:
not significant
TREATMENT HISTORY:
the pt was taken to RMP 3 days back for abdominal pain and vomitings ,where she was prescribed
Rabeprazole ,ondansetron,and metrogyl 400
This morning,after a seizure episode ,pt was given inj.midaz 2cc and inj.levipil 500mg IV/stat and referred to our hospital
TLC: 6600 cells/ cumm
RBC: 4.54 million/cumm
PLT: 2.44 lakh/cumm
PCV: 33.2 vol%
Neutrophils:88%
Lymphocytes:10%
MCV:72.8fl
MCH:23pg
Blood urea: 19 mg/dl
Serum creatinine: 0.8 mg/dl
Serum electrolytes:
Na+: 140 mEq/l
K+: 4.3 mEq/l
Chloride : 102 mEq/l
Total bilurubin:0.94mg/dl
Direct bilurubin :0.20 mg/dl
AST:16 IU/L
ALT:20 IU/L
Alk phosphatase:174IU/L
Total Protien:6.8gm/dl
Albumin:3.9gm/dl
CUE:
Albumin:nil
Sugars:nil
Pus cells:2-3/HPF
Epithelial cells:2-3/HPF
