Escolar Documentos
Profissional Documentos
Cultura Documentos
Case presentation :I present a case of 25 Year old Ms.S presented with chief
c/o Seizures of 3 years duration. Semmiology : GTCS semiology ,Upward rolling
of eyeballs,tongue bite present .No h/o urinary incontinence .Each episode
lasts 2-3 minutes with LOC followed by postictal confusion for 10 min. No h/o
aura or hallucinations. No h/o staring episodes or complex automatisms. H/o
Myoclonic jerks (which worsened with eptoin when she was treated outside).
Her current medications include tablet Encorate 300 mg Bid but her seizures
are not well controlled.No h/o head trauma. No h/o fever with ear discharge.
No h/o fever with neck pain,vomitings,altered sensorium. H/o voice hoarsness
since childhood . There is no h/s/o other cranial nerve dysfunction or bladder
dysfunction. No h/o weakness or sensory loss. No h/o swaying while walking or
cotton wool sensations or wash basin attacks. Past History: She was diagnosed
with a chronic skin disease(maculo papular skin lesions which initially started
as bullous lesions after sustaining trauma or pressure ). Biopsy was reported to
be s/o Lipoid proteinosis. Family history : she was born out of 30
consanguineous marriage. Other siblings are not affected. Her Menstrual cycles
are regular and she is unmarried. She desnot have any prior h/o drug
allergies,blood transfusions,surgeries. Her apetite is good.She eats a mixed
diet.Her sleep is adequate.There are no addictions. General examinations
revealed multiple papular lesions around upper and lower lid margins on both
sides.Several maculopapular lesions on both hands,around mouth.Scaly lesions
on palmar aspects on both hands.She has macroglossia. Nervous system
examination was unremarkable except for hoarse voice. Investigatrions:VLS
revealed thickened vocal cords,bulbous arytenoids.EEG was normal awake
record. MRI Brain revealed bilateral near symmetrical T1,T2 hypointense
lesions in amygdala and medial temporal lobes suggestive of calcifications.