Case
hemiphligia

Age: 75
Sex: Male
Race: normally built

History
History of present illness:
past three months on the right side of the body fully paralysed.He has aphsia, change in mental status,dysnea,loss of appitide,skin lesion evening feverbut his left side is normal.

Medical History:
he had difficulty in speech three months back at that time there is no paralysis in limbs
no diabates mellitus, no hyper tension no tubercolosis no HIV

Past surgical history:
appraximately 10 yers before he undergone hernial sugery

Allergies:
skin lesions

Medications:
hearin therapy
paracitomal
rantac
metrogel

Family history:
married
he has wife&2 daughters

Social history:
below poverty line


Physical Exam
General:
anemia -mild
pallor-slight
clubbing-no clubbing
lymphadenopathy-nolymphadenopathy
edema-no prephral¢ral edema
jaundice-no jaundice
cynosis-no cynosis

Temperature:
normally 98.7 f in morning in the evening slight increse

Heart rate:
74beats/min

Blood pressure:
132/84mmhg

Respiratory rate:
10/min

Oxygen saturation:
90/

Head, ears, eyes, nose & throat:
normal

Neck:
normal

Chest:
normal

Cardiovascular:
normal

Abdomen:
10 years back hernial surgery
loss of apptide

GU:
normal

Rectal:
normal

Neurological:
unnessary anger
beaten his wife
toilet fearness

Skin:
lesion on affected side

Laboratories:
routine bblood analysis wshows decrese hb levels
silght anemia
rest of thinghs are normal

Radiology:
we had taken x-ray on all the limbs bones are slightly demineralised
due to old age
we taken mri in brain it shows hemmorage in anterior branch of middle crebral artery.

Other:
muscle atropy
face weaknees

Pathology:
prepheral smear shows normocytic hypochromic cells
wbc-slightly increase
platelets -decresed

Problems:
hemmorage in anterior branch of middle crebral artery

Assessment:
rigt side hemipligia due top cerebral hemmorage

Plan of treatment:
we given heparin terapy

then we plan to do enaterectomy



Results of treatment:
slow pronosis

Discussion:
this my first case hemiplligia with speech disorder
speech disorder also due to hemmipllgia




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