Concluded Case

Late onset Epilepsy

Female in 50es came with generalised tonic-clinic seizure for 2 nd time with weakness and no fever. Same complaint before 3.5 years.. hemodynaemically stable... No travel history in last 1.5 months... MRI as under ... what can be DD and treatment options?

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Concluded answer

From the brief available history ,50 yr old lady presented with generalized tonic clonic seizure with background history of seizure about 3.5 yrs ago. Mentioned about weakness but no details available. MRI brain plain and contrast normal. Imp . LATE ONSET SEIZURE. Needs EEG ,complete metabolic work up including vasculitis.

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MRI looks normal GTCS s/o Epilepsy DD Metabolic dyselectrolytaemia Tetani Hepatic encephalopathy Porphyria epilepsia partialis NCC Tuberculoma SOL brain CHB Myxoedema seizures Poisoning Camfore

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From the brief available history ,50 yr old lady presented with generalized tonic clonic seizure with background history of seizure about 3.5 yrs ago. Mentioned about weakness but no details available. MRI brain plain and contrast normal. Imp . LATE ONSET SEIZURE. Needs EEG ,complete metabolic work up including vasculitis.

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TO ADD ONE POINT = STATUS EPILEPTICUS MEANS REPEATED ATTACKS OF SEIZURES WITHOUT GAINING CONCIOUSNESS IN BETWEEN SHE HAD TWO CONVULSIONS THIS TIME THIS CANNOT BE STATUS EPILEPTICUS

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MRI appears Normal . ** COVID * Status epilepticus Needs further investigation and evaluation to conclude and treatment plan. Till reports complied. Sedative SOS. Detailed family,personal history including injury . Multivitamin and antioxidants orally. Reassurance and councelling required.

Thanks Dr Sanjoy Sarkar
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

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MRI seems to be normal Is serum blood sugar, electrolytes normal? Go for video EEG

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On face of it MRI appears normal study Lady seems to be in status epilepticus

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Normal MRI Suggest EEG, metabolic parameters, causing seizures . Anti seizure prophylaxis suggested .

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Diffuse cerebral oedema

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Normal

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