27 YR OLD FEMALE WITH SEIZURES
27 year old female patient from Nakrekal came to the OPD with the ,
Chief complaints :
1 episode of Generalised tonic clonic seizures
HOPI:
Patient was apparently assymptomatic 12years ago ,then she underwent RTA followed by seizures ,for that she used medication .
8years ago ,She was diagnosed with thyroiditis associated with goitre for which she used carbimazole .
In 2015 - she underwent thyroid surgery ,where one lobe of thyroid is removed and continued on carbimazole
In 2021 -her 2nd lobe of thyroid removed along with parathyroid gland and started on thyronorm 100mcg -she is not on follow up since then .
After thyroidectomy Surgery in 2021 ,patient complaints of parasthesias in B/l lower limbs frequently ,for which she received multiple calcium injections but not relieved of parasthesias .
Now ,since 2 to 3 days she developed parasthesias , giddiness ,generalised weakness for which ,she was taken to local hospital in Nakrekal yesterday (i.e..,31st March at evening 5pm ) .
There ,Patient was started on Tramadol ,Neurobion and NS .
With in No time ,she developed clinching of fists ,frothing and tongue bite (ie..,1 episode of seizure ) followed by 10-15 mints of postictal confusion . Then she was given inj midaz 2CC and inj levipil 1gm IV stat and was referred to our hospital .
She also complaints of excessive thirst .
No H/O fever, altered sensorium ,head ache ,vomitings ,neck pain ,chest pain .
Past History :
not a known case of diabetes ,HTN ,Asthma ,epilepsy ,TB
Personal History :
Appetite : Normal
Diet : Mixed
Bowel and bladder movements : regular
Sleep -adequate
No addictions and allergies
General Examination :
Patient is conscious ,coherent ,cooperative
She is moderately built and moderately nourished
No pallor , icterus ,cyanosis ,clubbing ,lymphadenopathy , edema
Trousseaus sign :
vitals:
Temp : 98F
Pulse rate : 77bpm
Respiratory rate : 19cpm
Blood pressure: 120/80 mm hg
Systemic Examination :
CNS :
Higher mental functions -intact
Tone -normal
Muscle power -5/5
Reflexes - brisk
Cerebellar signs:
Finger nose test - normal
Dysdiadokinesia -normal
Sensory system - normal
Gait :
CVS :
S1 ,S2 heard
No murmurs
RS:
Normal vescicular breath sounds heard
No crepitations .
PA:
NAD
Investigations :
Provisional diagnosis :
SEIZURES due to HYPOCALCEMIA ( POST - PARATHYROIDECTOMY) .
Treatment :
