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 NS : intact

DIAGNOSIS

DYSTONIC TREMORS