A man of 35 years had fallen from the tree, 5 days ago.k/c/o epilepsy please see the report and suggest ur valuable opinions

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Reason for fall is due to recurrence of seizure or not. Ct brain no new lesions noted .Check he missed the med or not.What med he is on and what is the correct dose he is taking. How much is his weight?

Should be given oxcarbazepine 150 mg daily to begin with titrate add 150 mg / 4- 7 days till 450 mg 12 hrly, continue with periodic CBC, LFT and sodium level.
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He is kcof epilepsy And despite fall from tree no major changes in brain Just keep under observation and control the seizures Iwill suggest levitracetam

Ct finding reveal rt temporal gliosis.. No fresh infarct seen So it may be case of temporal lobe epilepsy and reason for fall may be episode of convulsion. Adv MRI it may be show mesial temporal screrosis

It is preferable to continue drug which he was talking in past if it was not controlled in past take a new e e g and compare with past if available .at the time of falling from tree was any damage done to head

Thank you doctor. First of all, I should aim at controlling the seizure by AED. I prefer Levipil - Lacosid synergy which may reduce the dose and at the same time the side effect. The gliosis at temporal lobe here may not act as a focus for the recent attack. Pt should be interviewed thoroughly for any other symptoms which may be correlated with the fall.

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Thank for the case . K/c/o seizure disorder . Old gliosis throwing seizures , if stabilized on levitracetam , continue with same . Any behavioural changes notied in patient with levitracetam shift to carbamazepam. Get base line cognative assessment .

Noted patient complains and patient’s. total assessment with adivse contuine on your routine medication and avoid this type of work...MNMS exam for further mangment of cognitive fuction.

TT conservatively n symptoaticall No obvious pathology seen

No lession noted Check the dose if he missed the dose Keep under strict observation

Right frontal contusion with dilated ventricles... need to evaluate with CT- C spine....need observation with neuro opinion...treat episodes of siezures, if recurrent...

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