Referral from HRPZ at 4.30 AM

Zuriah by Abdul Aziz
841113085124

35yo/malay/ lady
Adl independent 
Housewife
Para 2,day 5 post SVDat Husm (19/2/21)

Antenatally
1.intermitent maternal tachycardia
2.maternal obesity
3.involuntary subfertility
4.PE prophylaxis for 2 and 3

Discharge day 1 post svd, however baby refered to hrpz  for NNJ,pt came to HRPZ yesterday to fetch baby.

Noted pt fall from wheelchair in front of MAC 
- GTC 
-drooling of saliva, unresponse to call
-last 30secs 
-unsure fitting first or fall first
-post ictal drowsy but response to call and open eyes simultaneously 
-gain full consciousness after 2mins

Then 30min later,develope 2nd episode fitting 
-GTC
-last <1min
-regain full consciousness after 10mins
-given iv mgso4 

Then 15min later,develope 3rd episode of fitting
-GTC
-last 2mins
-aborted spontaneously
-post ictal drowsiness for 10mins then regain full consciousness

Ct brain done 
- large left frontal Intraparenchymal Haemorrhage 3x3cm
- small left frontal intraparenchymal haemorrhage



Currently,on vm 40% 
No fever
No more fitting in ward

O/e E4V5M6,obey command,pupil bilaterally reactive
Bp 129/68
Hr 92
T 37

Neurological examination no deficit

Given IV Keppra 500mg bd
On Valium 5mg prn