21 CASE PRESENTATION ON SEIZURE DISORDER.pptx

Case presentation on seizure

1. CASE PRESENTATION ON SEIZURE DISORDER SUBMITTED BY : 380021507521 III PHARM D

2. SUBJECTIVE : PATIENT NAME :Ms.C AGE :16Yrs SEX :Female COMPLAINTS ON ADMISSION: C/O fall due to giddiness , continuous convulsion for one hour . H/ O giddiness and headache × 2 days .

3. OBJECTIVE : PHYSICAL EXAMINATION : Sub conscious , Non - oriented, afebrile and Malaise . VITAL SIGNS: VITALS DAY TEMP ( °F) 98.6 BP ( mm / Hg ) 100/60 ↓ PR ( bpm ) 78 RR ( bpm ) 24

4. LABORATRY INVESTIGATION : CONSTITUENTS DETECTED VALUE NORMAL RANGE HEMATOLOGY : RBC 3.09 × 10 ⁶ / µl ↓ 4.5-5.5×10 6 /µl WBC 4.9 × 10 ³ /µl 4 – 11 × 10 ³ /µl PLATELETS 3.02 × 10 ³ /µl 150 – 400 × 10 ³ /µl HB 9.2g/dl ↓ 13-17g/dl PCV/HCT 32%↓ 40-50% ESR 14 mm ↑ 3-10mm MCV 81F 80-100F MCH 20 PG ↓ 27 – 32 PG MCHC 23 g/ dl ↓ 32 g/dl

5. SPECIAL INVESTIGATION : EEG : Epileptiform waves , seizure activity present CONSTITUENTS DETECTED VALUE URINE ROUTINE : COLOUR Clear EPITHELIAL CELLS 2- 5 PUS CELLS 3- 6

6. ASSESSMENT INTEREPRETATION : SUBJECTIVE : The patient admitted with the complaints of fall due to giddiness , continuous convulsion for one hour . History of giddiness and headache × 2 days . OBJECTIVE : The patient was Sub conscious , Non - oriented and Malaise . On laboratory investigation RBC , Hb ,PCV/HCT, MCHC and MCH levels are found to be decreased and ESR levels are found to be increased . On Special Investigation ECG shows Epileptiform waves , seizure activity present .

7. DIAGNOSIS : SEIZURE DISORDER , ANAEMIA , UTI .

8. DRUG TREATMENT CHART: BRAND NAME GENERIC NAME DOSE ROUTE FREQ DAY-1 DAY-2 DAY-3 inj.cerebyx Inj. Fosphenytoin 500mg PE/10ml IV BD  × × Inj.rocephin Inj. Ceftriaxone 1 gm IV BD    T.keppra T. Levetiracetam 500mg PO BD    T.Orofer XT Ferrous ascorbate+ folic acid 100 +1.5 mg PO OD    T.Pantop T. Pantoprazole 40mg PO OD    T.Mecovit T. Mecobalamine 10mg PO OD   

9. PLAN ON DISCHARGE T. Levetiracetam 500mg PO OD O Mecobalamin + folic acid+ Pyridoxine (1500 mcg+20 mg + 5 mg ) PO OD Review after 10 days .

10. PHARMACIST INTERVENTION : DRUG INTERACTION : FOSPHENYTOIN + FOLIC ACID ( Moderate ) Folic acid may decrease the serum concentration Fosphenytoin . MANAGEMENT : Monitor for reduced phenytoin concentrations and efficacy if combined with folic acid . Fosphenytoin dose increase may be needed.

11. PATIENT COUNSELLING BASED ON DISEASE : A seizure is a burst of uncontrolled electrical activity between brain cells (also called neurons or nerve cells) that causes temporary abnormalities in muscle tone or movements (stiffness, twitching or limpness), behaviors, sensations or states of awareness. Symptoms include Changes in emotion ,Loss of muscle control ,Shaking & Stiffness.

12. BASED ON DRUG : T. levetriacetam Do not drive or operate machine until you feel more alert. Proper and continuous medication is required for avoiding further occurrence of seizure . Avoid herbal supplements that can cause interaction with the given medication .

13. BASED ON DIET : Peas, beans , potatoes , nuts can help keep a steady energy level . Practicing keto diet would be helpful i.e; increased fat , low carbohydrate & increased protein diet. This help in controlling seizure episodes.

14. LIFE STYLE MODIFICATION : Take good rest ,enough hours of sleep . Avoid stressful situation , do not include in activities like swimming . Exercise regularly . Do meditation and yoga .

15. THANK YOU