RECURRENT STROKE IN A 69 YEAR CHRONIC ALCOHOLIC

69 year old male patient presented to our OPD with complaints of

WEAKNESS OF RIGHT LOWER LIMB FOR 4 DAYS
SLURRING OF SPEECH FOR 4 DAYS

Patient was apparently asymptomatic 3yrs back then all of a sudden developed Loss of speech following binge of alcohol without any limb weakness , had a Seizure episode, then he consulted a doctor where Neuroimaging was done(CT scan), He was given Treatment accordingly. He improved and was discharged. After discharge he took medicine for 5 months.

An year he had similar complaints of loss of speech following binge of alcohol , was taken to the hospital improved with glucose drip( according to the patient ).

Six months back patient he developed Weakness of all four limbs associated with Loss of speech.
He was admitted in our hospital this time.He also had Seizure episodes,irritable behaviour and recovered within 5 days and got discharged , was put on medication.
The evaluation included following-



He used the medication for a while and then stopped.

4 months back one fine day he had a fall(?Giddiness), local quack attended him and gave just pain killers. The patients attendant says he was diagnosed with hypertension and Diabetes but no documentation is available for the same.
4 days ago patient suddenly collapsed and developed weakness of right lower limb.

 He is a vegetarian
Bowek and bladder regular
no known allergies.
Regular alcohol drinker 90ml per day and 5 beedis per day.

 PNo significant family history .

Vitals were stable on admission.

CVS examination- S1S2 heard, No murmurs

RS examination - Bilateral air entry present,Normal vsicular breath sounds heard.

Per abdomen- Soft, Non tender, No organomegaly

CNS-
GCS- 15/15
Deviation of angle of mouth to right side present.
Inablity to whistle properly

Tone- Normal in all limbs
Power- 5/5 in left upper and lower limbs
             5/5 in right upper limb
             3/5 in right lower limb
Reflexes- Brisk right knee and ankle
Plantars- Flexor on left, Extensor on right.

Cerebellar signs absent

Hemiplegic gait











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