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    General Profile: - Pa - 6mos Old - Female - Filipino - Roman Catholic - Alang-Alang Mandaue City

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    Rj Fornolles
    This document describes the case of a 6-month-old Filipino female who presented with generalized tonic-clonic seizures. She had two seizure episodes over an 8 hour period with no associated fever or respiratory symptoms. On examination she was alert without focal neurological deficits. Initial workup including labs were normal. She was started on antiepileptic medication and remained seizure-free during her hospital stay. She was discharged with instructions to follow up as an outpatient.

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    General Profile: - Pa - 6mos Old - Female - Filipino - Roman Catholic - Alang-Alang Mandaue City

    Uploaded by

    Rj Fornolles
    126 views18 pages
    This document describes the case of a 6-month-old Filipino female who presented with generalized tonic-clonic seizures. She had two seizure episodes over an 8 hour period with no associated fever or respiratory symptoms. On examination she was alert without focal neurological deficits. Initial workup including labs were normal. She was started on antiepileptic medication and remained seizure-free during her hospital stay. She was discharged with instructions to follow up as an outpatient.

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    epilepsy

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    This document describes the case of a 6-month-old Filipino female who presented with generalized tonic-clonic seizures. She had two seizure episodes over an 8 hour period with no associated fever or respiratory symptoms. On examination she was alert without focal neurological deficits. Initial workup including labs were normal. She was started on antiepileptic medication and remained seizure-free during her hospital stay. She was discharged with instructions to follow up as an outpatient.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    126 views18 pages

    General Profile: - Pa - 6mos Old - Female - Filipino - Roman Catholic - Alang-Alang Mandaue City

    Uploaded by

    Rj Fornolles
    This document describes the case of a 6-month-old Filipino female who presented with generalized tonic-clonic seizures. She had two seizure episodes over an 8 hour period with no associated fever or respiratory symptoms. On examination she was alert without focal neurological deficits. Initial workup including labs were normal. She was started on antiepileptic medication and remained seizure-free during her hospital stay. She was discharged with instructions to follow up as an outpatient.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 18

    GENERAL PROFILE

    • PA
    • 6MOS OLD
    • FEMALE
    • FILIPINO
    • ROMAN CATHOLIC
    • ALANG-ALANG MANDAUE CITY
    CHIEF COMPLAINT

    • GENERALIZED TONIC-CLONIC SEIZURES


    HISTORY OF PRESENT ILLNESS

    • 8 HOURS PTA, PATIENT HAD ONSET OF GENERALIZED TONIC-CLONIC SEIZURES


    WITH UPWARD ROLLING OF EYEBALLS, CIRCUMORAL CYANOSIS
    • 6 HOURS PTA, PATIENT HAD ANOTHER SEIZURE EPISODE
    • NO FEVER, COUGH, OR CORYZA ASSOCIATED.
    PRENATAL, NATAL, POST NATAL

    • PRENATAL
    • BORN TO A 32 YR OLD G2P2 MOTHER POSTNATAL
    • 1ST PNC AT 2 MOS AOG AT LHC • FEEDING: BREASTMILK
    • WITH NO KNOWN MATERNAL ILLNESSES
    • PRENATAL MV: MV+ FE

    • NATAL
    • BIRTH RANK 2/2
    • DELIVERED VIA NSD AT A LYING IN CLINIC
    • GESTATION: FULL TERM
    • BW: 3,000 GRAMS
    • NO PERTINENT PERINATAL HISTORY
    • ENBS RESULTS: NORMAL
    IMMUNIZATIONS

    • BCG
    • PENTA HIB 1,2,3
    • OPV 1,2,3
    • PCV 1,2,3
    PAST MEDICAL HISTORY

    • UNREMARKABLE
    FAMILY HISTORY

    • HYPERTENSION ON MATERNAL SIDE


    • NO FAMILY HISTORY OF SEIZURES
    PHYSICAL EXAMINATION

    • AWAKE, ALERT, NOT IN RESPIRATORY DISTRESS


    • WT: 6.5 KG
    • VITAL SIGNS:
    • TEMP: 37
    • PR 131
    • RR 33
    • O2 SAT: 98 % AT ROOM AIR
    PHYSICAL EXAMINATION

    • HC:40.5CM
    • SKIN: WARM, GOOD TURGOR
    • HEENT: AIS, PPC, (-) LAD
    • C/L: ECE, CBS, NO RALES, NO WHEEZE
    • CVS: DHS, REGULAR RATE AND RHYTHM, (-) MURMUR
    • ABD: GLOBULAR, SOFT , NONDISTENDED, NO ORGANOMEGALY
    • EXT: STRONG PERIPHERAL PULSES, CRT <2 SECS
    • CNS: CN XII-NOT ASSESSED
    • CN I- NOT ASSESSED
    MENINGEAL SIGNS: NEGATIVE
    • CN II- NOT ASSESSED BRUDZINSKI’S SIGN AND KERNIG’S
    • CN III, IV, VI- PERRLA, EOMI SIGN
    • CN V- NOT ASSESSED
    • CN VII- NO FACIAL ASYMMETRY
    • CN VIII- HEARING NORMAL
    • CN IX, X- GAG REFLEX PRESENT
    ON THE DAY OF ADMISSION

    • PATIENT WAS SUBSEQUENTLY ADMITTED AND REFERRED TO PEDIATRIC


    NEUROLOGIST FOR CO-MANAGEMENT.
    • SEIZURE PRECAUTIONS
    • VENOCLYSIS STARTED WITH PNSS @27 CC/HR
    • THE PATIENT HAD 1 EPISODE OF GENERALIZED TONIC CLONIC SEIZURE WITH
    UPWARD ROLLING OF EYEBALL ASSOCIATED WITH CIRCUMORAL CYANOSIS
    LASTING FOR 1 MINUTE
    LABS

    CBC NORMAL PATIEN


    Normal Patient T
    Hemoglobin 11-20 10.6 L Serum Na 137-145 140
    Hematocrit 35-49% 30.7 L Serum K 3.5-5.1 4.7
    Platelet Count 140-440 392 Crea 0.7-1.2 0.20
    WBC 6.0-17.0 6.54 SGPT <35 23
    Differential count
    Neutrophils 45-65 33 CXR
    Lymphocytes 20-40 60 H
    Monocytes 2-9 5 CONSIDER A RETROCARDIAC
    Eosinophils 0-6 2 PNEUMONIA
    Basophils 0-2 0
    MEDICATIONS

    • DIAZEPAM 2MG IVTT PRN FOR ACTIVE SEIZURES WITH AD 0.3MKD


    HOSPITAL DAY 1
    • S: AWAKE, ALERT, NO RECURRENCE OF SEIZURES
    • O:
    • VITAL SIGNS: T 36 PR 112 RR36 O2 SAT 100% @RA
    • SKIN: WARM, GOOD TURGOR
    • HEENT: AIS, PPC, (-) LAD
    • C/L: ECE, CBS, NO RALES
    • CVS: DHS, REGULAR RATE AND RHYTHM, (-) MURMUR
    • ABD: SOFT , NONDISTENDED, NO ORGANOMEGALY
    • EXT: STRONG PERIPHERAL PULSES, CRT <2 SECS

    • A: EPILEPSY, GENERALIZED ONSET ETIOLOGY TO BE DETERMINED

    • P-STARTED ON OXCARBAZEPINE 60MG/ML 0.75 ML 2X A DAY


    HOSPITAL DAY 2
    • S: AWAKE, ALERT, ACTIVE, PLAYFUL, NO RECURRENCE OF SEIZURES
    • O:
    • VITAL SIGNS: T 37 PR 126 RR 36 O2 SAT 100% @RA
    • SKIN: WARM, GOOD TURGOR
    • HEENT: AIS, PPC, (-) LAD
    • C/L: ECE, CBS, NO RALES
    • CVS: DHS, REGULAR RATE AND RHYTHM, (-) MURMUR
    • ABD: SOFT , NONDISTENDED, NO ORGANOMEGALY
    • EXT: STRONG PERIPHERAL PULSES, CRT <2 SECS

    • A: EPILEPSY, GENERALIZED ONSET ETIOLOGY TO BE DETERMINED


    • P: STARTED ON OXCARBAZEPINE 60MG/ML 0.75 ML 2X A DAY WITH AD OF 7MKD
    • IVF SHIFTED TO HEPLOCK
    HOSPITAL DAY 3
    • S: AWAKE, ALERT, PLAYFUL, NO RECURRENCE OF SEIZURES
    • O:
    • VITAL SIGNS: T 36.2 PR 96 RR 36 O2 SAT 100 %@RA
    • SKIN: WARM, GOOD TURGOR
    • HEENT: AIS, PPC, (-) LAD
    • C/L: ECE, CBS, NO RALES
    • CVS: DHS, REGULAR RATE AND RHYTHM, (-) MURMUR
    • ABD: SOFT , NONDISTENDED, NO ORGANOMEGALY
    • EXT: STRONG PERIPHERAL PULSES, CRT <2 SECS

    • A: EPILEPSY, GENERALIZED ONSET ETIOLOGY TO BE DETERMINED


    • P- CLEARED FOR DISCHARGE
    DISCHARGE INSTRUCTIONS

    • TAKE HOME MEDS:


    • OXCARBAZEPINE 60MG/ML 0.75 ML 2X A DAY

    • EEG AS OUTPATIENT
    THANK YOU

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