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Laxmikutty Amma ,72yrs/F 06/06/01

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Provisional Diagnosis-SHTN/Amlo induced edema Rt Hemicrania (Trigeminal Neuralgia) ?Temporal arteritis Osteopenia
Final Diagnosis-Trigeminal Neuralgia(Inadequate Rx) SHTN Vit D Def state GERD
History and Findings-Referred by Dr.Rahul Laxman (Pain & Paliative AIMS) H/o Rt Hemicrania,bone pains,bipedal edema of long duration.K/c/o SHTN on Rx,trigeminal neuralgia x 30yrs no relief on Rx
Investigation-Previous inv:MRI Brain 15/1/04-N study,pre op serology-neg,CAG 06/06/06-N study,CT Brain 27/10/07-N study,MRI c spine 03/05/08-Diffuse disc bulge C5,C6,Pap smear Dec 2009-Neg for malignancy,CT Brain Oct 2010-N study,A/g-3.9/2.7,TFT-Normal,RBS-179,Hb-12.5,ESR-30. present Inv:Hb-11.6,ESR-36,uric-5.5,HBA1c-6%,Ca-9.1,P-3.9,Ck-138,25(OH)vit D-10.92,S.B12-1161,Alb-4.22,Glob-3.26,Total chol-231,Tg-213,LDL-148,HDL-39,urine RE-Blood 1+,8-10 RBCs/HPF,HBSAg Neg,Doppler study temporal arteries-N study,OGD scopy 17/0/11-LA-A esophagitis,Pangastritis
Treatment-Rx before present consultation Tab.Ultracet,Imipramine,Evion,Dom DT,Amlong,Gabapentin,artificial saliva Present Rx:stop Amlodipine & Gabapentin Tab.Telma 20mg od,Tab.Pregabalin 75mg 0-0-1 increased to 1-0-1,carbamazepine (Mezetol)added subsequently increased to 200mg 1/2-1/2-1,Calcirol sachets 1gm in milk wkly once for 3months & then once monthly,Milical 1000mg 0-0-1,Tab,Pan 40mg od before food
Follow Up-Pt V.neuralgia & RT hemicrania improved remarkably with normal sleep & bone pains responded to calcirol & oral calcium
doctor bhaskaaran

doctor bhaskaaran

wkfvcepdupscibtlbsbo, http://www.lmyhjkaety.com iaroburchp

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