John Pattison, a 35-year-old male, presented to the emergency department after experiencing a two-minute seizure with rhythmic jerking of his limbs and facial muscles while at work. He has a family history of epilepsy in his sister and has experienced seizures every 2-3 months since age 32. An EEG showed evidence of generalized epileptiform discharges, leading to a final diagnosis of generalized epilepsy. He was discharged on daily antiepileptic medications and advised to follow up with his neurologist and maintain a healthy lifestyle.

1. DEPARTMENT OF
NEUROLOGY
EPILEPSY
PRESENTED BY:
POOJA GHOSHAL
59m-

2. PASSPORT DATA
Name : John Pattison
Age : 35 Years
Gender : Male
Address : Khotenska,ivano frankivsk

3. PATIENT COMPLAINTS
John presents to emergency department as he had seizures which lasted for 2 minutes
and was having rhtmic , jerking muscle movements of limbs,,eyeballs,fasicial muscle,
salivation.

4. ANAMNESIS OF DISEASE AND ANAMNESIS
OF LIFE
 The patient had seizures with lasted for 2 minutes while he was working at office. The
patient had some rhythmic jerking movement of limbs,facial muscles.Patient was
admitted to emergency department.
 The patient has a family history of epilepsy,his sister has the same condition.
 Patient had his first seizure when he was 32 years old and since then,he has been
experiencing seizures every 2-3 months.
 The seizures are usually generalised and he also experiences convulsions and jerking
movement of his arms and legs during seizures.
 The patient has been prescribed antiepileptic drugs by his neurologist to treat seizures.
 THe patient has not missed any doses and also made some lifestle changes such as
getting enough sleep,avoiding alcohol and caffeine and managing stress.

5. PHYSICAL EXAMINATION
 The patient was alert and oriented on examination.
 There are no signs of trauma or injury.
 Vital signs are within normal limits.

6. PRELIMINARY DIAGNOSIS
 Metabolic disorders(hypoglycemia,hyponatremia).

7. DIAGNOSTIC TESTS
 Complete blood count,electrolye balance,LFT were done
 EEG , Mapping of biochemical activity,DETERMINING 3-D imaging of localised
epileptic activity, MRI CT SCAN OF BRAIN
 All blood tests including LFT,CBC ,electrolyte levels were all within normal limits.
 A head CT SCAN was performed and showed no acute abnormalities.
 An EEG(ELECTROENCEPHALOGRAM)was performed which showed evidence of
generalised epileptiform discharges consistent with a diagnosis of genearlised
epilepsy.

8. DIFFERENTIAL DIAGNOSIS
 Paroxysmal dyskinesias
 Hyperventilation
 Prolonged QT syndrome and other arrythmia
 Metabolic disorders
 Pseudoepileptic seizures or non epileptic seizures
 Encephalopathie

9. FINAL DIAGNOSIS
 EPILEPSY,GENERAL SEIZURES

10. TREATMENT
 Antiepileptic drugs daily dosage,
 Valproate—20/30mg/kg
 Topiramate –- 3-6--(9)mg/kg
 Lamotrigine --- 1-5---(10)mg/kg
 Phenytoin---5-7mg/kg
 Ketogenic diet should be followed
 Physiotherapy and psychotherapeutic sessions
 In case of vagus nerve stimulation,surgical care is needed.
 Avoid alcohol,caffeine and stress management.

11. FOLLOW UP
 The vitals were stable and no seizure was reported further so patient was
discharged.
 The patient was called for a follow-up next week
 The patient has been advised to take daily dosage of AEDs and visiting
neurologist every two month.
 Maintaining a healthy life style was recommended and diet modifications were
made for avoiding future complications.

12. THANKYOU :)