60 year old female with convulsions

 

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A 60 year old female, resident of Nalgonda district, farmer by occupation, presented with 

CHIEF COMPLAINTS:

Involuntary movements and loss of consciousness 

HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic 20 years ago, when she had a history of fall, followed by injury on the head.   

              Following which, 5 years later, when she was working in the fields, she had an attack of sudden involuntary movements in her upper limbs and loss of consciousness because of which she collapsed on ground. This episode lasted for 2-3 minutes. After regaining her consciousness, she did not seem to remember the events. She was taken to a nearby hospital, where she was treated and was given medications.

            There is history of another episode, 10 years later, following which she stopped working working in the fields as per advise of a doctor in a local hospital.

           Currently, she was admitted to the ophthalmology ward for senile cataract for which a surgery was to be scheduled. While she was in the ward, she had another attack during which she fell down from the bed. There was involuntary movements of hands, fore arm and face, with eyes closed, it lasted for 1 min, and regained consciousness and started speaking in the next 1 minute.After which she was brought to the AMC for treatment. She had laceration on inner side of lower lip, for which sutures were given. 

The patient had revealed that she has not taken medication since past 3 days.

Apart from these, there is history of 5 more attacks, not followed by collapse/ fall. 

PAST HISTORY: 

There is h/o trauma to the head 20 years back

There is no h/o HTN, DM, thyroid abnormalities, asthma

PERSONAL HISTORY:

The patient is married, has 2 children.

Was Previously a farmer but now she is a homemaker.

Daily routine:

Previously, she uses to wake up early, go to the fields and work.

She used to come back home, has lunch and goes back to field in the evening. She used to work and come back by night, has dinner, does household work and sleep. 

Now,  She wakes up in the morning, cleans the house, cooks and has breakfast .

She does household chores and has lunch.

The she just takes rest at home.

FAMILY HISTORY:

No history of similar complaints in the family