hypoglycemic seizures

 A 36  year aged male came to the opd in the hypoglycemic state with seizures.

Cheif complaints

Seizures since 1 week 

HISTORY OF PRESENTING ILLNESS

Patients was asymptomatic 1.5 yrs back, was diagnosed with diabetes mellitus .

 Since 1 week during night, during sleep he was developing seizures .Which would last for a short duration (15 min)and resolve spontaneously .The seizures are clonic seizures with uprolling eye movements and exaggerated body movements.

He is  also diagnosed with gynecomastia 

N/H/O of frothing , tongue bite

PAST HISTORY

K/C/O of diabetes .On insulin therapy.

1 year back he had pricking sensation in the feet which was diagnosed to be associated with high dosage of insulin and hypoglycemic drugs. For which there was change in the dosage.

N/K/C/O HTN,ASTHMA,TB

PERSONAL HISTORY

Diet :mixed

Appetite :normal

Sleep :adequate

Bowel and bladder movements :regular

VITALS

BP:90bpm

PULSE RATE:126/64mmHg

RESPIRATORY RATE:

RBG: 25 mg/dl

GENERAL EXAMINATION

Patient was conscious and coherent.

No pallor,icterus, lymphadenopathy,cyanosis,clubbing and edema.

CVS

S1,S2 heard ,No murmurs

RESPIRATORY SYSTEM

No wheeze ,No dyspnea

Vesicular breath sounds heard




INVESTIGATIONS:











PROVISIONAL DIAGNOSIS

Uncontrolled sugars 2 ° to uncompliance  

CKD ?( diabetic nephropathy)

Gynecomastia.

TREATMENT

Day 1

GRBS monitoring 

IV fluids

Inj optineuron

Day 2

Inj Human ACTRAPID SC TID Acc to GRBS

GRBS monitoring 

Inj optineuron



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