Seizures which affect initially only one hemisphere of the brain. Symptoms include: Contractions on just one side of the body unusual head or eye movements Numbness, tingling, or a feeling that something is crawling on the skin Abdominal pain Rapid heart rate or pulse Sweating Nausea

1. PRESENTED BY:
Makbul Hussain Chowdhury
Pharm. D 4th year

2.  Hemiparesis is weakness of the entire left or right side of
the body. Hemiplegia is its most severe form, complete
paralysis of half of the body. Hemiparesis and hemiplegia
can be caused by different medical conditions, including
congenital causes, trauma, tumors, or stroke.
 Hemiplegia is identified by Radiological studies like:
CT scan
Magnetic resonance imaging of the brain should be used to
confirm injury in the brain and spinal cord

3.  Seizures which affect initially only one hemisphere of
the brain. Symptoms include:
◦ Contractions on just one side of the body
unusual head or eye movements
◦ Numbness, tingling, or a feeling that something is
crawling on the skin
◦ Abdominal pain
◦ Rapid heart rate or pulse
◦ Sweating
◦ Nausea

6.  Patient Name: Xxx
 Age: 45yrs
 Gender : Male
 Department: General Medicine( MMW)
 DOA:25/11/18
 Chief Complaints:
weakness in left upper and lower limbs since 3 days

7.  Past medical history:
Known case of CVA
On medication: Amlodipine 50mg,
Ecospirin (150/20)mg
 Personal history:
Diet: Mixed diet
Sleep: normal
Bowel and bladder habits: regular
Appetite: normal
Occupation: Farmer
Alcoholic, smoker

8.  GENERAL EXAMINATION:
PR:136b/min
BP:120/70mm Hg
RR: 21b/min
 BRAIN CT:
Parieto-occipital subcortical and deep white matter, likely
sub acute to chronic infract.

9. S.NO LAB TESTS LAB VALUE NORMAL VALUE
1 ALT 56 IU/L 5-36IU/L
2 AST 61 IU/L 5-40IU/L
3 PLASMA GLUCOSE 109mg/dl 70-110mg/dl
4 HEAMGLOBIN 10.6g/dl 13-14g/dl
5 T. WBC 12,600C/cu mm 4000-11000c/cu mm
6 NEUTROPHILS 55% 54-62%
7 LYMPHOCYTES 40% 25-33%
8 EOSINOPHILS 4% 7-10%
9 MONOCYTES 1% 1-3%
10 Platelet count 89,000C/cu mm 150,000-450,000c/cu
mm
11 PCV 33% 40-52%
12 MCV 92.5 fl 78-98fl
13 MCH 28.8 pg 27-35 pg
14 MCHC 31.1% 31-37%

10. SEIZURES WITH RIGHT
HEMIPARESIS

11. S.NO BRAND
NAME
GENERIC
NAME
INDICATIO
N
DOSE ROA FREQUE
NCY
DURATI
ON
1 EPTION PHENYTOIN ANTICONV
ULSANTS
100mg IV TID 4 DAYS
2 FOLVATE FOLIC ACID B- VITAMIN 5mg PO OD 4 DAYS
3 CEFTRIAX
ONE
CEFTRIAXO
NE
ANTIBACT
ERIAL
1mg IV BD 4 DAYS
4 RANTAC RANITIDINE ANTACID 150mg IV BD 4 DAYS
5 ECOSPRIN ASPIRIN ANTICOAG
ULANT
150/20m
g
PO OD 4 DAYS
6 STAMLO AMLODIPIN
E
CALCIUM
CHANNEL
BLOCKER
2.5mg PO OD 4 DAYS
7. TAXIM CEFOTAXIM ANTIBACT
ERIA
100mg PO BD 1 DAY

12.  DAY 1:
Patient conscious, oriented
Temp: afebrile
PR: 136b/min
BP: 120/70 mm Hg
Tongue bite + ve
CNS: slurring of speech
Medication: inj. eptoin, T.folvite , inj.ceftrioxone, inj. Rantac ,
T.ecospirin T.stamlo

13.  DAY 2:
Patient conscious, oriented
Temp: afebrile
PR: 120/min
BP: 120/80 mm Hg
Medication: cst
 DAY 3:
Patient conscious, oriented
Temp: afebrile
PR: 88b/min
BP: 110/80 mm Hg
Medication: ceftriaxone was stopped, tab.taxim was
added

14.  DAY 4:
No fresh complaints
BP: 110/70 mm Hg
PR: 88b/min
Medication : same

15.  To eliminate seizures or reduce their
frequency to the maximum degree possible.
 To evade the adverse effects associated with
long-term treatment, and to aid patients in
maintaining or restoring their usual
psychosocial and vocational activities, and in
maintaining a normal lifestyle.
 To stabilize the patient and to complete initial
evaluation and assessment, including imaging
and laboratory studies

16. REGARDING DRUGS:
 PHENYTION: anticonvulsant drug used primarily in the
management of complex partial seizures, taken along with
food.
 STAMLO: Amlodipine relaxes blood vessels and
improves blood flow, used to treat high blood
pressure, taken once daily.
 ECOSPIRIN: Aspirin also a blood thining medicine,
reduces the risk of harmful blood clots.

17.  FOLIVITE: This medication is a vitamin, prescribed
for anemia due to vitamin C deficiency. It helps the
body make healthy new cells.
 TAXIM: Cefixime is an oral cephalosporin antibiotic.
 DUPHALAC: Lactulose is a type of sugar used to
treat chronic constipation.

18. LIFE STYLE MODIFICATIONS:
 The best preventive measure is to comply strictly with the
drug regimen as prescribed
 Maintain a healthy diet, including plenty of whole grains,
fresh vegetables, and fruits.
 The ketogenic diet, which is very high in fat (90%), very
low in carbohydrates, and low in protein
 Avoid drinking alcohol.

19.  Develop routine sleep.
 Strengthening leg muscles and balance through
exercises
 Taking precautions when taking medications that cause
drowsiness