drsaranya: 38/F with Seizures and Other CNS Findings.

I am Saranya ,a final year MBBS student.

Greetings to all my readers;

This is an elog documenting the patients that I witness during my Clinical Postings to enforce a greater patient centered learning .

DEIDENTIFICATION :

The privacy of the patient is being entirely conserved. No identifiers shall be revealed through out the piece of work whatsoever.

Introduction :

Here we shall discuss our patient who is a 38 year old lady hailing from a village in South India .She is a tailor by occupation.

Presenting Picture of the patient :

BACKGROUND

Almost all her 38 years of life have been if a different shade as compared to any other of her contemporaries.

This is because when she was 3 year old ,one day she experienced fever for a day and then the next day she developed inability to move both her lower Limbs.

Since then she has grown up with the help of mechanical support to substitute her lost power in her lower Limbs.

Fast Forwarding to 20 days before the day of presentation to our Hospital ( henceforth shall be referred to Hospital2)

She developed high grade fever , cough with sputum , headache.

She took medications prescribed by a local physician

After a couple of days , since any of the symptoms mentioned above weren’t subsiding

She was taken to a local hospital ( Hospital1 )

There the attenders were told that she has low hemoglobin ( 5gm/dl ) and was transfused 3 units of packed cells .

Post other medications administered by Hospital 1 her fever subsided but other problems did not.

4 days prior to presentation to Hospital 2

She developed weakness in her Right upper limb and Right lower Limb , slurred speech and disorientation.

She also had seizure episode that night and couple of days even after that.

She was taken to the same Hospital1 once again where they referred her to Hospital 2 and thus she presented to us.

Note : No seizure episode has been witnessed since admission to Hospital2 on 30.10.21.

DESCRIPTION OF THE DAY THE PRESENT ILLNESS DEVELOPED :

Since she was not keeping well since the last 20 days ,her husband used to keep a check on her health via telephone from his workplace ( a restaurant cook )

On his call that day , she mentioned to him that she wasn’t feeling quite well ,and by the time he returned home after work ,he reports that her eyes had a blank stare , she could identify him but she spoke few words which were slurred ,did not carry any meaning and then she stopped speaking .

Some time later she threw a seizure episode wherein her husband gives history of eye rolling and tongue bite.

After which she was taken to Hospital 1 and then Hospital 2.

CHRONIC DISEASES :

She is not a known case of DM ,HTN ,Bronchial Asthma ,TB, Thyroid.

DAILY ACTIVITIES :

She consumes mixed diet , with a slightly lessened appetite since the past fortnight , sleeps adequately , bowel and bladder Normal

No history of any involuntary passage of urine or stools

She is not a smoker ,she doesn’t consume alcohol.

No known food or drug allergies.

FAMILY HISTORY :

No similar complaints in any of her immediate family members.

No history of sudden deaths in the family.