75 year old male came with loss of speech and dizziness


Chief complaints: decreased

responsiveness


HOP1: 75 yr old male patient farmer

by occupation brought to casualilty 

with decreased responsiveness 5:00 am.On examination, his blood glucose level was 43mg/dl.


Negative History : No History of Headache,Fever,Vomiting ,Chest Pain,Palpitations and Shortness of Breath.


Past history: Patient had similar complaints of decreased responsiveness 5 years ago due to low blood glucose levels and was diagnosed with diabetes mellitus, 

treated for that in a local hospital.On diabetic medication.

Other-

Hypertension 

Coronary artery disease 

Asthma 

Epilepsy 

Alcoholic since 45 years 


Treatment History : For Diabetes 

Glimda-MV 2



Personal History: Mixed diet

Polydipsia polyuria polyphagia

Bowel And Bladder-Regular 

 Sleep Adequate 

No Allergies And Addictions.

Alcoholic 


Family History: not Significant 


General Examination: 

Patient is Conscious, 

Moderately Built and Nourished.

Pallor Absent

Icterus Absent

Clubbing Absent

Cyanosis Absent

Lymphadenopathy Absent

Edema Absent

Vitals : 

Temperature - 98.6 degrees F

Pulse 52 bpm

B.P 120/80mmHg

SpO2 97%.


CNS :


Higher mental functions


 • conscious


 • memory - able to recognize their family members


 • Speech - Normal


Sensory system : responding to pain


CEREBRAL SIGNS

 Finger - Nose In - Coordination - No

Knee - Heel In-coordination - No

 

Reflexes: Left limb-

Biceps  ++

Triceps ++

Supinator ++

Knee ++

Ankle ++


Right limb-

Biceps ++

Triceps ++

Supinator ++

Knee ++

Ankle ++


Lab diagnosis: 












Treatment:- 

IV fluids DNS 50ml/hr

Inj Optineuron 1 amp in 100 ml

Inj 25% dextrose IV 

Tab Pantop 40mg 

GRBS monitoring 


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