A 84 yr old male with tremors, swelling and increased urination
A 84 year old male with tremors, swelling, and increased micturation
MEDICAL CASE
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CASE DISCUSSION:
A 84 year old male agricultural by occupation brought with complaints of
- Tremors since 4 years
- Slowness of movements and walk since 6 months
- Forgetfulness since 6 months
- Recurrent h/o falls since 6 months
- Polydypsia and polyuria since 10 days
- Sweeling in the left lower limb since 1 week.
Patient was apparently asymptomatic 4yrs back then he developed - involuntary movements in both upper and lower limbs, he has recurrent h/o falls, slowness of movements and walk, forgetfulness since 6 months.
H/o fall 10 days back- lost incisor teeth- change in voice since then.
Polydypsia and polyuria since 10 days with occasionally urinary incontinence and burning micturation.
H/O injury to lower limb 1 week back ( sweeling)
Presently- complained of increased thirst and frequent micturation.
Patient was an agricultural, he stopped working 20 years ago after the death of his wife, Who hanged herself 5 months after the diagnosis of endometrial carcinoma due to hot flushes.
He consumes alcohol 90ml /day since age of 20 years.
He used to smoke cigarettes, stopped smoking 3 months back.
PAST HISTORY:
Not a k/c/o - DM,TB,ASTHMA,EPILEPSY
H/o head injury beatten by someone when he was around 25yrs.
PERSONAL HISTORY:
- Mixed diet
- sleep is adequate
- Appetite normal
- bowel movements - regular
- Increased frequency of micturation
FAMILY HISTORY:
No similar complaints in family
H/o head injury beatten by someone when he was around 25yrs
GENERAL EXAMINATION:
PR-84bpm
Bp-110/70mmhg
Spo2- 98 on RA
CVS-S1,S2 +, no added sounds
RS- BAE +
P/A-Soft,NT
O/E:
Mask like face
Temporal wasting +
Thin built
B/L UL, LL tremors +
Tone: left ( UL, LL normal)
Right( UL, LL normal)
Wrist ( increased)
GAIT: festinating, turning slow
Power: 5/5 in all limbs
CLINICAL IMAGES:
INVESTIGATIONS:
DIAGNOSES: ? PARKINSON'S DISEASE left lower limb injury ( swelling)
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