55/F altered sensorium since 10 days
55 year old female ,farmer by occupation Was brought to casualty in altered sensorium since 10 days Patient was apparently asymptomatic 15 days ago Then developed fever - for 2 days ,high grade , with chills Then on day 3,4 - patient developed involuntary movements (tremors ) of both upper limbs With weakness of both upper limbs from day 4 And slurring of speech Taken to outside hospital in day 5 Found to have hypoglycemia (grbs -27 mg/dl ) Since admission in outside hospital Patient developed altered sensorium Fluctuating sensorium+nt ( unable to recognise people sometimes ) Self talking +nt Hallucinations+nt Involuntary micturition+nt Irrelevant talking +nt No involuntary defecation , involuntary mivuemk Diagnoses as - acute gastroenteritis with dehydration Acute kidney injury ? Metabolic encephalopathy Recurrent hypoglycemia Type 2 dm Hypertension...