Escolar Documentos
Profissional Documentos
Cultura Documentos
Case details
11 yr old male child Product of non consanguinous marriage Informant- father Resident of BHIWANI(HARYANA) Reliability -good
Presenting complaints
One episode of loss of consciousness with generalized seizures - 24 hrs before Weakness of left upper limb x 24 hrs Headache 24 hrs
Apparently well child till one day back while playing carrom ,he developed pain and numbness in left upper limb. Soon he developed generalized seizures
Associated with loss of consciousness Deviation of angle of mouth Up rolling of eye balls Lasted for 03 minutes
HOPI contd
H/O WEAKNESS UPPER LEFT LIMB Acute onset,involving elbow ,wrist and finger grips NonProgressive HEADACHE
NEGATIVE HISTORY
No H/o of
NO BOWL/BLADDER INCOTINENCE NO POOLING OF SALIVA,DYSPHAGIA,NASAL REGURGITATION FLUSHING/SWEATING/GIDDINESS FEVER COUGH CHEST PAIN OR PALPITATION VOMITING/DIARRHEA
PAST HISTORY
FAMILY HISTORY
Nonconsaguinous marriage No h/o seizures,neurological disorders Mother has completed ATT course 07 yrs back for pulmonary T B .
13yrs
11yrs
IMMUNISATION HISTORY
DEVELOPMENTAL HISTORY
SOCIAL HISTORY
11 yr old male child apparently well 1 days back, presented with h/o one episode of generalized seizures of 3 minutes duration followed by weakness and numbness in upper left limb and frontal headache with family h/o pulmonary tuberculosis in mother 07 yrs back,had completed ATT course
General examination
Child is conscious ,oriented to time, place ,sitting on bed comfortably Afebrile Pulse- 88/min,all peripheral pulses well felt,sinus arythmia R/R- 20/min BP- 110/68mm Hg RAS CFT < 2 sec No pallor /icterus /cyanosis/ clubbing/lymphadenopathy/ pedal oedema No neurocutaneous markers
Anthropometry
CNS
Fundoscopy normal
CNS contd
MOTOR SYSTEM
UL LL
N N
Power
Power UL LL
Rt
Lt
CNS contd
reflex RT LT
Resp
B/L equal air entry vesicular breath sounds
SUMMARY
11 yr old male child apparently well 1 days back, presented with h/o one episode of generalized seizures ,presently having some weakness in left upper limb and frontal headache
INVESTIGATIONS
Hb-12.3gm% TLC-9500 DLC-P53 L41 Platelets- 2.6 lacs PBS for MP- Neg ICT for MP VE BUN-10 Creatinine- 0.8
INVESTIGATION
Na 140 K 4.2 Cl 101 Ca 3.6 repeat 4.4 Urine normal LFT normal CPK 14 U/L Montoux test negative
CXR normal ECG normal USG abdomen normal MRI Brain showed ring enhancing lesions in posterior parietal lobe Rt side with perilesional edema,suggestive of tuberculoma.
DIAGNOSIS
FINAL DIAGNOSIS
MANAGEMENT
Definitive
ATT
Supportive
STEROIDS ANTI EPILEPTIC Watch out for SEIZURES
COURSE IN HOSP
Child was seizures free Showed improvement in power in left upper limb Got relief from headache Tolerating ATT well
THANK
YOU