Patient suffering from Alcohol withdrawal syndrome

This is an online E log book to discuss our patients de-identified health data shared after taking his/his guardian signed informed consent . Here we discuss our individual patient's problems through a series of inputs from the available global online community of experts with an aim to solve those clinical problems with collective current best evidence based input 


This is case of a 40 yr old male patient came to casualty with  history of Involuntary movement of bilateral lower extremity  since 2days

CHIEF COMPLAINT : 

Patient came to casualty on 16/3/22 with involuntary movement of legs since 2days .




DURATIONS : 

GTC type seizure.
Lasting for 3min not a case of uprolling of eyes , tongue bite , involuntary micturition , 
2 episodes per day .
Was taken to local hospital  and was treated conservatively .




PATIENT HISTORY : 

Patient was asymptomatic 2days back . Then he developed pain in the bilateral lower extremity .
He fainted when he was in his work and he wasn't conscious until the patient family brought him to the hospital . He has alcoholic habit from past 20 years and also has smoking habit  as the same time being.




PRESENT ILLNESS HISTORY :
No similar complaints in the past . No history of head trauma , chestpain , palpitations .



HISTORY OF PAST ILLNESS : 
No diabetes mellitus and no hyperstension.
 Patient is a alcoholic from past 20years and also have smoking habit for the same time being .
Patient is a farmer and does his daily routine activities . He  has stopped his alcoholic habit fr 10days few years back . But then started the habit again . 
Later he stopped the habit again until  thn his third son died 6months back . So he started drinking again. 
Then he was admitted to hospital 2days back. 




TREATMENT HISTORY 
No hypertension
No diabetes mellitus 
No CAD 



PERSONAL HISTORY
MARRIED 
Occupation: Farmer
Appetite : Normal 
Mixed diet 
Alcohol : Regular 
Smoking : Regular 


FAMILY HISTORY
No related family history 



GENERAL EXAMINATION
Temp :  98.5
Pulse rate 99/min
Respiration 18/min
Bp 110/80

SYSTEMIC EXAMINATION 

CVS
Cardiac sounds : Both S1 S2 heard



RESPIRATION
No Dyspnoea 
No wheeze 


ABDOMEN
Shape of abdomen : scaphoid 
No Tenderness 


CNS
Level of consciousness : 
Conscious


Speech : Normal 



PROVISIONAL DIAGNOSIS : 
Alcohol withdrawal seizure



INVESTIGATIONS : 

Hemogram : 

Hb : 7.6
TLC :  1,700
PCV : 22.8
MCV : 102.7
MCH : 34.2
MCHC : 33.3 
RBC : 2.22





 

ECG : 





Rx : 

25% Dexture IV
IV NS RL 100ml/hr
Inj.PANTOP 40mg/IV/OD
INJ.LORAZEPAM IV / SOS
W / F SEIZURE ACTIVITY










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