dementia with epilepsy
Chief complaint:
78 yr old male patient complaints of dementia with hypertension
Hypertension since 9 months
Dementia with epilepsy of 5 episodes
History of present illness:
Patient was apparently asymptomatic 6months back then he developed forgetting things which are usually done everyday . He doesn't remember anything after the seizures and usually talks about past work
Patient was usually thinking and mumbling about certain things which were done in the past and couldn't do his own things like urine and cleaning
Incontinence of loss of urine control is seen
Patient was shown to neurologist and medication were given accordingly
He had suspected of bradycardia and hypertension so decrease the medication dose 3 days back
Patient also had fever 3 days ago
C/o tremors since 3 to4 yrs
Slurring of speech ,relevant, coherent 2 yrs
Mumbling about not doing work since 6 months continuously
Negative history:
No h/o head injury
No h/o hearing of voices,self talking, strange behaviour
Noh/o low mood, suicidal thoughts,
No h/o palpitations,fear, shortness of breath
No h/o diabetes
No h/o thyroid and cad
Past history:
History of hypertension
Family history:
No psychiatrical problems in the family members.
Marriage: consanguinous
Had 4 children in that only one child is alive and 3 are dead
1 St child died because of health issues and was chronic alcoholic
2nd child died in a road traffic accident
3rd child is alive and lives separately
4th child died due to in-laws problems and committed suicide
Treatment history:
Initiative medication:
Tab.DONEPEZIL(5mg) for 3 days
Tab. CLONAZEPAM(0.25mg)
After 2 days changed to
Inj. Levipil (1gm iv stat)
/500mg iv stat
Watchout for seizures
On the next day :
Inj . Optineuron (1 ampoule) 500ml
Inj levipil500mg iv (tid)
Inj . sodium valproate500mg iv tid
Inj lorazepam
Tab. Donapezil and CLONAZEPAM
Personal history:
Mixed diet
Normal appetite
No known allergies
Normal micturition
Stopped alcohol 5 yrs back
