Case presentation of generalized seizure

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Category: Education
     
 

Presentation Description

This is a case of generalized seizures in a child of 5yrs.of age.The important thing in this presentation is the use of Glasgow coma scale, VTS technique,Ketogenic diet.

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Presentation Transcript

A case presentation on generalized seizures : 

A case presentation on generalized seizures Presented by Arvind Kumar M.Pharm. (Pharmacy Practice) NIPER Guwahati

Patient’s profile : 

Patient’s profile Age 5 Yr. Sex Male Weight DOA 06-10-09 Ward Pediatrics 12 Kg

Chief complaints : 

Chief complaints Fever X 1 day abnormal movement X 15-20 sec Loss of consciousness X 3hrs

investigations : 

investigations

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Continue…. EEG Reports 8-10hz ;40-50 mv α activity from both occipital areas Getting attenuated by eye opening α mixed with generalized θ and anterior dominant fast activity. Provocation with photic stimulations

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Continue…. CT Scan Report No significant parenchymal abnormality is present.

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CONTINUE…. : 

CONTINUE….

GLASGOW COMA SCALE : 

GLASGOW COMA SCALE VERBAL RESPONSE EYE OPENING MOTOR RESPONSE

DIAGNOSIS : 

DIAGNOSIS GENERALIZED SEIZURES DISCHARGE

Dose calculation : 

Dose calculation e.g. for ceftriaxone Weight = 12kg , BODY SURFACE AREA = 4 X weight +7 90 + weight = 4 X 12 + 7 90+13.5 = 0.539 Sq.m CHILD DOSE = BSA X ADULT DOSE = 0.539 X 2 ≈ 600mg 1.73 1.73

Medication chart : 

Medication chart

Pharmaceutical issue : 

Pharmaceutical issue Ceftriaxone Ceftriaxone can cause rise in liver enzyme level, so careful monitoring should be done. Ceftriaxone may lead to hypoprothrombonemia ,bleeding and haemolysis.

Continue…. : 

Continue…. Sodium valproate Dose dependent side effect Dyspepsia, nausea, vomiting, hair loss, anorexia, drowsiness. Non dose related side efffect Acute pancreatitis, aplastic anaemia, thrombocytopenia, hepatotoxicity

Non-pharmacologic treatment : 

Non-pharmacologic treatment VNS Technique Ketogenic diet

Patient counseling : 

Patient counseling To observe that child will not develop fever To observe precautions To keep the seizures record To attend follow up clinic regularity

suggestion : 

suggestion Patient’s Hb level was low, but no step was taken to improve it. Evaluate liver function, platelet count, and PT at baseline and monthly intervals. Monitor plasma level and make dose adjustment as needed.

Continue…. : 

Continue…. MRI should be done Monitor for tremors, which may indicate need for dose reduction.

Any query : 

Any query ?

Thank you : 

Thank you