Question

Description

Mr. Franklin is a 60-year-old patient with a history of a thrombotic cerebrovascular accident two years ago. After the stroke he started with seizure attacks. He has been suffering from hypertension for the last ten years and ulcerative colitis since last year. He currently takes lisinopril, hydrochlorothiazide, aspirin, carbamazepine, and a low dose of prednisone.

Mr. Franklin has been suffering from epigastric pain, sensation of fullness, and occasional nausea for the last six months. This time, he was brought to the ER because, while he was talking to his son, he had a dizzy spell and fell to the floor. He is conscious and is complaining of severe epigastric pain. He began with mild abdominal pain two days after he started taking a new cycle of prednisone for his colitis, around seven days ago. The pain increases when he eats or drinks something. He is also complaining of suffering from pyrosis, malaise, and dizziness, and he has noticed that his feces are dark.

The patient was a heavy alcohol drinker until he had the stroke. He is a cigarette smoker since he was 20 years old. His mother suffered from Alzheimer's disease and died of colon cancer, and his father died of cirrhosis of the liver.

• Abdomen: Pain on palpation on epigastric region
• SOMA: Right hemiplegia and hyperreflexia
• Integumentary system: Pallor, diaphoresis, coldness
• Cardiovascular system: Tachycardia. Blood pressure 70/50 mmHg. Radial pulse 110.
• Digestive system: Tenderness of epigastric region. Rectal exam showed melena.
• Neurologic system: The patient is conscious and well oriented to time, place, and person. Right hemiplegia and hyperreflexia.

Answer the folowing

1. Mr. Franklin, had dizziness and was found on the floor. What traumatic brain injuries do we have to rule out?
2. How do we clinically know if the patient was having a seizure attack?

Answer 1

Mr. Franklin had dizzines and was found on the floor. What traumatic brain injuries do we have to rule out?

Mr. Franklin is a 60years old male patient is chronic cigarette smoker and alcoholic and suffering from hypertension since 10year onwards. Have a history of thrombotic cerebral vascular attack 2 yers ago..At the time of event patient is conscious and well oriented to time, place and person . Right hemiplegia and hyperreflexia present. Right hemiparesis caused by brain injury (stroke ) results in a varying degree of weakness and spasticity and lack of control one side of body.

2)How do we clinically know if the patient was having seziure attack.?

While taking history after the first stroke ,seizure episodes started and now continuing medicines on timings. Tab. Carbamazepine.