A dancing patient

Dr. Ahmed Al Montasir

Particulars of the patient Name Md Rokonuzzaman Age 40 years Village Hapuria Post Koromgi P.S. Dhupchachia District Bogra Date of 17th May, 2011 admission

Presenting complaints
Involuntary movement of the whole body for the last two years

History of present illness

According to statement of the patient he was resonably allright two years back then he developed involuntary, jerky movements at the extrimities. Gradually the involuntery movement also involed the trunk. The jerky movement present all the time even during sleep, not altered by rest or movement. In the last two years his speech also became soft, indistinct. His attendent mentioned about loss of long term memory of the patient.

Past history
There is no history of jaundice, fever with joint pain in the past.

Family history

Socioeconomic condition
Patient is a autorickshaw driver. His daily income average between 150 to 200 Tk.

Personal history
Mr. Rokonuzzaman is non smoker, non alcoholic.

Treatment history
For the last two years the patient have taken several medications but all the efforts were in vein.

General examination Appearance Anxious Body build Average Decubitus On choice Anaemia Absent Jaundice Absent Cyanosis Absent Clubbing Absent Koilonychia Absent Leuconychia Absent JVP Not raised

General examination Lymph node Thyroid gland Oedema Skin condition Hair distribution Temperature Pulse Blood pressure Respiration Body weight Not palpable Not enlargel Absent Normal Normal 980 F 80/ min 110/80 mm Hg 16/ min

Examination of the nervous system Higher psychic function Orientation in time place and person Memory Long term Short term Immediate recall Calculation Abstract thinking Visual and body perception Intact

Impaired Intact Intact Preserved Intact Normal

Examination of the nervous system Cranial nerves All the cranial nerves are intact Intact Motor system Bulk of the muscle Equal both side Tone of the muscle Normal Muscle power 6/6 both side in both upper and lower limb

Examination of the nervous system Motor system Orientation in time place and person Memory Long term Short term Immediate recall Calculation Abstract thinking Visual and body perception Intact

Impaired Intact Intact Preserved Intact Normal

Examination of the nervous system Higher psychic function Orientation in time place and person Memory Long term Short term Immediate recall Calculation Abstract thinking Visual and body perception Intact

Impaired Intact Intact Preserved Intact Normal

Examination of the nervous system Higher psychic function Orientation in time place and person Memory Long term Short term Immediate recall Calculation Abstract thinking Visual and body perception Intact

Impaired Intact Intact Preserved Intact Normal

Examination of the nervous system Higher psychic function Orientation in time place and person Memory Long term Short term Immediate recall Calculation Abstract thinking Visual and body perception Intact

Impaired Intact Intact Preserved Intact Normal

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Presenting complaints
Involuntary movement of the whole body for the last two years