18 yr old female, resident of narketpally, complains of 3 episodes of seizures since yesterday night

Pt was apparently asymptomatic till last night, at 12 am, in her sleep, she had an episode of gtcs with tongue bite, dribbling of saliva, post ictal confusion and uprolling of eyeballs and gained consiousness after 10min

Similar episodes took place at 4am and 11.30am

No involuntary micturation or defecation

C/o headache in frontal region, non radiating
C/o nausea since morning

No fever, cough, cold, chest pain, orthopnea, pnd, burning micturation, loose stools, vomitings

K/c/o seizures since 1yr, used medication for 1 month, and stopped after that

No palor, icterus, cyanosis, clubbing, lymphadenopathy, edema 

Vitals:
Pr 108 bpm
Bp 110/70 mmhg
Rr 14 cpm
Spo2 99%
Grbs 92 mg/dl

Cvs: s1,s2 normal
Rs: BAE present 
P/A: soft, non tender 

CNS:
Pt is conscious, 
Speech is normal
No meningeal signs
Normal cranial nerve examination, motor system, sensory system
Gcs: E4,V5,M6
Reflexes:
       R L
B +++ +++
T +++ ++
S ++ ++
K +++ +++
A +++ +++
P Flexor Flexor


Diagnosis:
Seizures under evaluation

Treatment:
Inj levipil 500mg iv bd
Inj optineuron 1amp in 100ml ns iv od
T zofer po sos
T dolo 650mg po sos
Iv fluids
Monitor vitals

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