So ?GTCS case is actually an electrolyte imbalance case

So that case which I had posted yesterday, I got his electrolytes report today in which sodium is quite low and potassium is borderline too Check attached case below Management Please give your valuable comments regarding electrolytes imbalances correction in this case

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Chronic alcoholic with hyponatremia Kindly look for liver disease, as Hyponatremia is common in patients with cirrhosis and portal hypertension, and is characterized by excessive renal retention of water relative to sodium due to reduced solute-free water clearance. The primary cause is increased release of antidiuretic hormone

So should I go with diuretics sir? In a resource limited setting, cant get an ABG done here sir.

Must try to find out osmolarity of blood and urine as well as Na level of urine also Try to categories hyper, hypo or iso osmolar hyponatremia Treatment changes as per it's type Also look for any drugs which can precipitate hyponatremia and stop it As of now treat slowly with adding AEDs

Valuable opinion

Severe hyponatremia responsible for convulsions Correction of hyponatremia By iv inj NS Inj dextrose Oral tab resodium

Thanx dr Anil Gangani

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Hyponatremia Low chloride Give NS


Give Inj Kesol 1 amp i v Liquid kesol 2 tsf bd Inj NaCl 25 ml iv Inj G N S 500 ml I v drip


You may be at a higher risk for having generalized tonic-clonic seizures if you have a family history of epilepsy. A brain injury related to a head trauma, infection, or stroke also puts you at higher risk. Other factors that could increase your chances of having a grand mal seizure include: sleep deprivation an electrolyte imbalance due to other medical conditions the use of drugs or alcohol Treating generalized tonic-clonic seizures If you’ve had one grand mal seizure, it may have been an isolated event that doesn’t require treatment. Your doctor could decide to monitor you for further seizures before beginning a long-term course of treatment. Antiepileptic medications Most people manage their seizures through medication. You’ll probably start off with a low dose of one drug. Your doctor will gradually increase the dose as needed. Some people require more than one medication to treat their seizures. It may take time to determine the most effective dose and type of medication for you. There are many medications used to treat epilepsy, including: levetiracetam (Keppra) carbamazepine (Carbatrol, Tegretol) phenytoin (Dilantin, Phenytek) oxcarbazepine (Trileptal) lamotrigine (Lamictal) phenobarbital lorazepam (Ativan) Surgery Brain surgery may be an option if medications aren’t successful in controlling your seizures. This option is believed to be more effective for partial seizures that affect one small part of the brain than for ones that are generalized. Supplemental treatments There are two types of supplemental or alternative treatments for grand mal seizures. Vagus nerve stimulation involves implantation of an electrical device that automatically stimulates a nerve in your neck. Eating a ketogenic diet, which is high in fat and low in carbohydrates, is also said to help some people reduce certain types of seizures.

Tab.Nacl : 2g ×3 daily 8hrly for 7 days, ORS: to drink, No IV fluid should be loaded as it may dilute the blood sodium further.


Rx Punarnavshatak qwath BD Galo ghan tab 1bd are helpful

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