Seizures case

August 10, 2020

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CASE DISCUSSION:

20yrs male ,butcher by occupation studied till class 7th.In2011 he had right focal seizures of 1episode and was admitted to the hospital for 1week and used antiepileptic medication for about 2years.In 2014 he had his 2nd episode of rt focal seizures. ?NCC on MRI and was on albendazole and steroids used antiepileptic drugs for 1year and also used herbal medications.

In 2018 he had acute onset of SOB, abdominal tightness and constipation he was admitted in lb nagar kamineni xary was done showing peural effusion and he was diagnosed with TB for which he was prescribed ATT for 6months and stopped the medication on his own without any follow up.

ATT USED FOR 6MONTHS

Then on 09-08-2020 @12am patient noticed spasm of right upper limb for 5min and then woke up,then noticed involuntary movements of right upper limb and then to all the limbs.

Uprolling of eyes and head posturing along with tounge bite was present. Post Icteal confusion was present for half n hr.patient had such similar 6episodes-right focal with secondary generalisation.

Patient when presented to casualty was conscious and well oriented.Then he developed involuntary movements of right upper limb which progressed to generalised tonic clonic seizures with uprolling of eyes,head posturing towards left and drooling of saliva.episode lasted for 5min and pt was unresponsive, regained consciousness after 5min with postictal confusion for about half n hr headache present.

No history of neckpain,fever,trauma,neckstifness and weakness.History of rawmeat consumption and pork consumption present.Not a known case of diabetes hypertension and asthma no family history of seizures present.

Ictal cry, bowel and bladder incontinence,aura were absent.

On examination:

Patient is conscious, coherent , co operative

oriented to time , place and person,

moderately built and nourished

VITALS:

Patient was afebrile with

Bp-110/80mmhg

Pulse-86 bpm

RR-22cpm

Spo2-97% at room air

No pallor, icterus,cyanosis, clubbing, koilonychia, lymphadenopathy and pedal edema