Page 1 of 1: MEDICINE-DIAGNOSIS

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

60 YEARS OLD MALE PATIENT WITH 32 YEARS OF C.O.P.D. WAS WITH NO OTHER ABNORMALITY & NICELY PERFORMING HIS ALL DUTIES WAS FOUND BY HIS WIFE IN A FINE MORNING TO SLEEP UPTO 7 P.M.[USUALLY HE RISES BY 6 P.M.] & NOT ANWERING TO HER QUERIES WITH A VACANT LOOK.
SHE SUMMONED HER DOCTOR SON FROM UPSTAIRS WHO FOUND HIS BLOD PRESSURE TO BE 140/100[WHICH WAS 90/60 THROUGHOUT PATIENT'S LIFE] mm hg.THERE WAS TACHYCARDIA & THE PATIENT COULD NOT REMEMBER ANY INCIDENT FOR LAST 3-4 MONTHS.PATIENT WAS TELING HE WAS FELING WEEK[HE WAS NOT UNCONSCIOUS].THERE WAS NO SENSORY DEFICIT ON ANY SIDE BUT LITTTLE WEAKNES[GRADE 4] ON RIGHT SIDE. THE DOCTOR SON GAVE HIM ALPRAZOLAM 1 Mg.,THE PATIENT SLEPT ALL THE DAY & WHEN HE RECOVERED FROM SLEEP ,B.P. & HEART RATE WERE ABSOLUTELY NORMAL.
NEXT MORNING CT SCAN OF BRAIN DONE & EVERYTHING WAS WITHIN NORMAL LIMIT[NO ABNORMAITY DETECTED].
PATIENT WAS DIAGNOSED AS T.I.A. & WAS KEPT ON "CLOPIDOGEL". ONE MONTH AFTER THIS INCIDENT[IN BETWEEN WHICH THE PATIENT WAS VENTURING ABSOLUTELY NORMAL & STRESSFUL LIFE WITH EASE],ONE FINE MORNING AT 6-45 A.M. THE PATIENT HAD AN ATTACK OF HEADACHE FOLLOWED BY CONVULSION WITH FROTHING IN MOUTH WITH MICTURITION WITH PULSE RATE-110/MINUTE & B.P.120/96 mm hg.
HE WAS BROUGHT TO HOSPITAL & WAS GIVEN MANNITOL & PHENYTOIN Na AFTER WHICH THE PATIENT BECAME CONSCIOUS[HE WAS UNCONSCIOUS FOR 2 AND HALF HOURS].
ECG WAS DONE & AN OLD INCOMPLETE BIFASCICULAR BLOCK WAS NOTED.
SERUM BILIRUBIN WAS 2.2mg%[DIRECT 1.2 & INDIRECT 1 mg%].
" MRI SCAN OF BRAIN WAS DONE & MULTIPLE LACUNAR INFARCT WERE FOUND.
BRAIN WAS A LITTLE BIT ATROPHIED & VENTRICULAR SYSTEM A BIT ENLARGED.
ALSO THE ANTERIOR PORTION OF EACH TEMPORAL LOBES WERE DEGENARATED." NOW WHAT IS YOUR DIAGNOSIS?

1.C.V.A.
2.ALZHEIMER'S DISEASE.
3.TEMPORAL LOBE EPILEPSY.
4.NONE OF THE ABOVE.
ANSWER GIVEN IS TEMPORAL LOBE EPILEPSY.
PLEASE HELP MY FRIENDS.
THANKX A LOT.

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

THIS IS VERY IMP. FOR AIIMS &AIPGME.
NO ONE TO ANSWER !!!!!!!!!!!!!!!!!!!!!!!!
HEY FRIENDS,COME ON.
DEAR MODERATORS,COME ON.
HAVE A SAY.
THANKS.

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

HEY,FRIENDS & MODERATORS,COME ON.

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

SO,NO IDEA

FRIENDS

Sucaprio · Credits: 125 My Scrapbook

I think the answer is temporal lobe epilepsy. The patient had the sezure at normal blood pressure plus CT brain show changes in temporal lobe to support the diagnosis.

NO h/o increased rick of thrombus or emboli formation.

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

YA FRIEND YOU ARE RIGHT,
THANKS FOR POSTING.
REGARDS.

robin · Credits: 2035 My Scrapbook

I think it is CVA. The temporal lobe findings on imaging are not specific for temporal lobe epilepsy. It looks like the past event is a TIA and the current one is a bleed and bleed may be missed on MRI - it requires a plain CT. This is a close call. Because the past event could very well be complex partial seizures (left side - as pt. couldn't speak and has rt. side weakness), but it can't be temporal lobe, it has to be frontal. And the present h/o of headache followed by seizure - it is either a bleed or embolus, both of which can be missed on MRI.

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

NO BOSSS.
IT'S A CONFRMEDE CASE OF TEMORAL LOBE EPILEPSY.
THANKS FOR POSTING.
REGARDS.

mdi · Credits: 250 My Scrapbook

temporal lobe palsy

jayanta · Credits: 38219 My Scrapbook My Reading List 45 Books

YA.

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