Learning points:-

I have learned about treatment plan of epilepsy 

Mechanism of action of phenytoin in epilepsy

Maintenance and loading dose in epilepsy

Adverse effects of phenytoin in therapeutic range

Importance of levitriacetam in status epilepticus

I have learned how to auscultate bronchial breath sounds

In community acquired pneumonia case:-Characteristic difference between inspiratory and expiratory sounds of bronchial breath sounds(inspiration- gushing expiratory-hollow)

In CKD case:- how to examine distended abdomen, how to perform fluid thrill, how to perform shifting dullness 

OSCE:-

-causes of unexplained onset of seizures in adults 

various structural and functional causes can be responsible for late onset of seizures with unexplained origin

-cerebral small vessel ischemic disease 

-accumulation of amyloid beta

-hyperphosphorylated tau

-sleep apnea

https://pubmed.ncbi.nlm.nih.gov/31481308/

IDIOPATHIC GENERALISED EPILEPSY

While late-onset IGE (IGE with an age at onset of above 26 years) is not common, one should consider the possibility of its occurrence in adults with new-onset seizures. This condition shares many of the clinical and electroencephalographic features of classical IGEs, which supports the hypothesis that IGE syndromes in different age groups share common biological determinants.

https://www.jocn-journal.com/article/S0967-5868(20)30327-1/fulltext


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