A 75 year old male with complaints of involuntary movements of right upper limb.

February 03, 2021

Case history:

75 year old male patient resident of peddakaparthy who's a farmer by occupation complained of involuntary movements in right upper limb for 10 mins on 30/1/21

History of present illness:-

Patient was apparently asymptomatic 15 days back, then he developed involuntary movements, tongue bite +, slurring of speech +.No one was present at the time of epsiode..It lasted for upto 15 min..He was confused till 1 hour post that episode and a known person brought him home.Since then he had difficulty in chewing food,he is able to do his daily activities.Since 5 days back,he is having weakness of his right hand..he is unable to mix the food and put it in his mouth..On 30/1/21 he is having involuntary movement of right upper limb, tongue bite absent, drooling of Saliva present and weakness of right upper limb

No c/o fever,cold, cough

No c/o chest pain, palpations, syncopal attacks

No sob,orthopnea,PND, abdominal pain

C/o burning micturition

No c/o constipation and loose stools

Past history- DENOVO hypertension diagnosed 15 days ago and on Clevidipine 10 mg/PO/OD, irregular medication

PERSONAL HISTORY:

patient has non veg diet, sleeps adequately,has decreased appetite, normal bowel and bladder movements, drinks alcohol since 30 years 90 ml/day..No history of smoking..

General examination:

Patient is conscious, coherent and cooperative

Oriented to person, not to time and place

Appears to be malnourished

No signs of pallor,icterus,cyanosis, clubbing, lymphadenopathy,edema

VITALS:

On Examination :

PR 96 bpm, BP 150/90 mmHg, RR 18cpm, Temp 98.4°F, SPO2 98%

RS - BAE +,NVBS

CVS-S1 S2 heard, no murmurs heard

P/A -soft, non tender

CNS