Journal of Emergency and Internal Medicine

Trilogy: Epileptic seizure, stroke and possible neuro psychiatric lupus, a diagnostic challenge in isolated area

Joint Event on 8^th Edition of International Conference & Exhibition on Pain Management, Physiotherapy & Sports Medicine & 9^th Edition of International Conference on Internal Medicine & Patient Care
March 18-19, 2020 London, UK

Rakhmad Ramadhan

Agats General Hospital, Indonesia

ScientificTracks Abstracts: J Emerg Intern Med

Abstract

Introduction: Seizure can affects people of ages, races, and ethnic backgrounds. This can cause changes in awareness, behaviour, decrease brain function, and/or abnormal motoric and sensory loss. First onset of seizure should be finding the etiology. Epilepsy is a common complication after stroke, and epilepsy increase risk of stroke. There is an association between epilepsy, stroke, and systemic lupus erythematosus. Case Report: Male, 22 yo, came to Agats hospital, with acute onset decrease of consciousness presenting with seizures. General seizures were unprovoked with sign of lateralization. Diagnosis epilepsy was made, stroke and neuropsychiatric lupus was made as differential diagnosis due to young and middle-aged adults onset. Patient presented with E1V1M1, blood pressure 140/90 mmHg. Complete blood count shows within normal limit. Random blood sugar was 110 mg/dl. Human immuno deficiency virus (HIV) three methods show non-reactive result. Neither head CT scan nor was electroencephalography (EEG) not available in the hospital. Referral access was also to be limited due to geographically isolated area and limited transportation resources. Based on American College of Rheumatology criteria for Lupus, also could not be excluded. Antiepileptic drugs carbamazepine was given (the intravenous antiepileptic drugs was not available), multivitamin and neurotropic agents for stroke, and steroids was given for Lupus possibility. After a week of treatment, patient had already got improvement, and then got full consciousness. Conclusion: Epileptic seizure, stroke and neuro psychiatric lupus, have a diagnostic challenge in isolated area. Treat possibilities and education have an important role.

Biography

Rakhmad Ramadhan has completed his internist from Brawijaya University, Indonesia. He is the Internist at Agats General Hospital, Asmat district, Papua, Indonesia. He concern about serial unique cases that found in isolated area, due to the low education of civilization, primitive thinking about healthy, the limited resources to perform supporting examination and treatment, and limited access to referral treatment.