DYSTONIC TREMORS
Patient came to the opd with c/o tremors since 20 years HOPI He wakes up at 6am in the morning and drinks tea, eats rice at 11 am and lunch at 1 pm and dinner at 8 pm and sleeps at 9pm He underwent appendicectomy surgery 14 years back He had tremors from 11 to 20 years of age He is on eptoin for 10 years From 5years he has no seizure episodes Past history N/k/c/o DM,HTN, EPILEPSY, ASTHMA Family history Not significant Personal history Diet - mixed Sleep - adequate Appetite- normal Bowel & bladder- regular No addictions General examination Patient is c/c/c Oriented to time ,place , person No pallor, icterus , cyanosis, clubbing, koilonychia , lymphadenopathy,edema Vitals BP- 110/80 mmHg PR-72 Bpm RR -16cpm Temp-98.6F Systemic examination CVS - S1S2+,NO Murmurs RS -BAE+,NVBS HEARD P/A-SOFT ,NON TENDER CNS- Pt is c/c/c Tone: R-UL-N, L-UL- N R- LL- N, L- LL- N Power: R-UL:5/5 L-UL:5/5 R-LL:5/5 L-LL:5/5 Reflexes:R, L B: +,+ T: +,+ S: +,+ K: +,+ A: +,+ Sensory system: NAD Cranial
