In addition, he notices a little bit of swelling. He has a little bit in the upper arm on the left, but nothing on the right arm, a few areas on his chest wall and abdomen, as well. They do not seem to be as bad as his left arm. There has been no numbness or tingling in his arm. He has been trying to keep it covered as best he can.
She has noticed no significant voice changes and no other symptoms suggestive of underlying tissue disorder. On examination, she was well looking. The cough today was present throughout the consultation and was a mixture of throat clearing and a dry laryngeal cough. Peripherally there was no clubbing, she was saturating at 99% on room air and her lung fields were clear. Examination of her oropharynx revealed moderate degree tonsillar enlargement, but these were not reddened and she believes they are longstanding.
There were no difficulties with Minnie’s birth and postnatal development. Minnie has meet all developmental milestone at the expected ages. Minnie has adequate vision, and well developed hearing. At the age of 4, when Minnie’s younger brother was born, she developed nocturnal enuresis. These episodes were brief in duration and are not of current concern.
During the seizures she did not lose any consciousness or had no incontinence. Basically she has focal seizures. They are not generalized, limiting duration and not associated with headaches, dizziness or visual disturbances, no vomiting and no other associated symptoms. Mostly she is noted to have a long-standing history of bipolar disorder followed by psychiatry as an outpatient. The patient
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