13 year old male with new onset seizures

13 year old male school  student came with :

C/O 1 episode of seizure.

H/O present illness:

Patient was apparently asymptomatic 1 day back then he developed 1 episode of sudden onset giddiness,fall on 18/12/21 at 4.30 PM followed by clenching of both fists,frothing and tongue bite.

Loss of consciousness present. 

Post ictal confusion present for 1 hour followed by headache.

H/O nose bleed 1 episode present.

No H/O ear bleed.

Past history:

Not a k/c/o DM,HTN,asthma,TB.

H/O febrile seizures 2 years ago.

Personal history:

Diet-mixed 

Appetite-normal

Sleep-adequate 

Bowel and bladder movements-regular 

General examination:

Patient is conscious, coherent, cooperative 

No pallor,icterus,cyanosis,clubbing,koilonychia, lymphadenopathy, edema. 

Vitals on admission:

TEMP- 99°F

BP-110/70MM OF HG

PR-92 BPM

RR-16 CPM

SpO2-98% @RA

Systemic examination:

CVS- S1S2+

RS-BAE+

CNS-NO FND

CLINICAL IMAGES:

INVESTIGATIONS:

TREATMENT:

•INJ. LEVIPIL 300MG IV BD

•INJ. LORAZ 2CC IV SOS

•W/F SEIZURE ACTIVITY 

•INJ. OPTINUERON IAMP IN 100 ML NS IV OD

•TAB. DOLO 650 MG PO SOS

•INJ. NEOMOL 1 GM IV (IF TEMP>101°F)

•TEMP CHARTING 4th HOURLY

ENT REFERRAL I/V/O NOSE BLEED: