Epilepsy with Bilateral Pitting Edema

Male patient aged 40 years presented with complaints of pain in suprapubic region,and has history of holding urine for long period of time as he works in a very busy shop. His vitals are WNL O/E - Bilateral pitting edema present in legs No H/O HTN and DM Kindly note he is on antiepileptics sodium valproate and phenytoin in BD dose for last 20 years without any episode of seizure. Ordered a KFT, LFT, URINE RM, USG KUB. What could be probable differentials??


Triphala kashaya washing. Jatyadi ghrta or Vranahari Taila for External application. Dashanga or Doshagna Lepa for surrounding area of the wound. It should not touch the wound. Internally, Maha Manjistadi Kashaya,Varunadi Kashaya, Sahacharadi kashaya, Triphala guggulu, Kaishora guggulu, Gandhaka rasayana. And treat this case as Gambhira Vatarakta.
Holding of urine is voluntary as suggested Yes vesical calculus or uretheral stricture should be r/o Pedal oedema needs investigations As pt is on antiepileptics for a long time
Thanx dr Dinesh Gupta

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R/o vesical calculus Oedema could be secondary to holding of urine voluntrarly or side effects of long term medication Further evaluation is required for diagnosis of oedema
R/o BPH perform USG Abd and Pelvis too
Look for BPH, UTI , Ureteric stone Decrease the dose of antiepileptics