38 male with hypoglycaemic choreoathetosis

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The patient and the attendees have been adequately informed about this documentation and the privacy of the patient is being entirely conserved. No identifiers shall be revealed throughout the piece of work whatsoever.



PRESENTING COMPLAINTS: 


A 38 -year-old patient came to casualty with chief complains of involuntary movements of bilateral upper limbs and lower limbs, face and slurring of speech on & off during nights since 3 days.


HOPI: 


Patient was apparently a symptomatic 3days back, Then he started developing involuntary movements of whole body (upper and lower limb ,face) which was sudden in onset and gradual in progression associated with slurring of speech .Each episode lasted for a 10 - 15 minutes . It is relived spontaneously.


Not associated with loss of consciousness ,tongue bite, frothing,unrolling of eye ,defecation,micturition.


PAST ILLNESS:

B/l breast lump (hard , circular mass below nipple) which patient noticed 20 days back


K/C/O Type2 DM since 1and half year .

H/O cataract surgery in right eye.

N/K/C/O HRN/CAD/asthma/epilepsy.


PERSONAL HISTORY:

Appetite normal.
Sleep adequate.
Bowel and bladder are regular.
No allergies.

FAMILY HISTORY:
Mothers has diabetes since
No Comorbidities.

GENERAL PHYSICAL EXAMINATION:
Moderately built and poorly nourished.
Patient was conscious and cooperative.
Oriented to time, place and person.
Pallor, clubbing and lymphadenopathy absent.
Cyanosis, pedal edema are absent.
PR : 75bpm; 
BP: 120/70mmHg; 
RR: 15cpm; 
SpO2: 99%@RA; 
GRBS: 20 mg/dl
CVS: S1,S2+; 
R/S: BAE+;
 P/A: Soft, Non tender, BS+; 
CNS: NFND.

Past history 

K/C/O Type2 DM since 1and half year .

H/O cataract surgery in right eye.

N/K/C/O HRN/CAD/asthma/epilepsy.







Diagnosis 

Hypoglycaemic choreoathetosis sec to insulin overdose 

CKD ? Diabetic nephropathy

B/l gynecomastia - breast lump 

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