A 38yr old male with involuntary movements

 A 38yr old male patient presented to the Opd with chief complaints of 2 episodes of involuntary movements since 1 week

History of presenting illness 

Patient was apparently asymptomatic 1 week back he developed involuntary movements during sleep lasting for 15 minutes involving whole body which resolved spontaneously which was noticed by his mother 
Not associated with loss of consciousness up rolling of eyes frothing micturition defecation 

History of past illness 

K/c/o type 2 DM on medication insulin

Cataract surgery 

Personal history 

Normal appetite 
Mixed diet
Normal bowel and bladder movements 
Adequate sleep
Occasional toddy drinker

Family history 

DM and HTN - mother 

General examination 

No Pallor icterus cyanosis clubbing pedal edema lympadenopathy

Systemic examination 

CVS system
No thrills
Cardiac sounds are heard
No cardiac murmurs

Respiratory system
No dyspnoea 
No wheeze
Trachea is centrally positioned 
Vesicular breath sounds

Abdomen 
Scaphoid shape abdomen 
No tenderness, palpable mass
Normal hernial orifices

CNS
Conscious 
Intact cranial nerves

Provisional diagnosis

Uncontrolled sugars secondary to non compliance 







Investigations





















Treatment 

Day 1

GRBS monitoring 

IV fluids

Inj optineuron

Day 2

Inj Human ACTRAPID SC TID Acc to GRBS

GRBS monitoring 

Inj optineuron



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