A 45 YR OLD MALE WITH INVOLUNTARY MOVEMENTS OF UL AND LL

A 45 old male who was has been having a diabetic foot (necrotising fascitis on the plantar aspect of left foot)since 3 months since then he has been undergoing debridement procedure and then and had SSG 10 days ago.He was a diabetic patient since 10 yrs.
He is a farmer by occupation.
He had h/o toe amputation 3 yrs ago.
The patient had seizure like activity yesterday night ( tonic clonic type) with loc.
GCS - 6/15
O/E 
Pt is drowsy but responding to commands
Bp - 110/70 mmHg
Pr - 84 /min
CVS - s1 s2 +
R/S - BAE+
P/A- soft , non tender 
CNS - E 4 V 2 M 4
Both UL and both LL tone normal 
Power - Moving upper limbs and rt. Lower limb.
Reflexs-
B ++
T ++
S ++
K ++
A ++
Pupils -Rt - reactive to light, Lt - mild dilated unresponsive.




Diagnosis - SEIZURE LIKE ACTIVITY DUE TO HYPONATREMIA.
?SIADH
?ATN
?Chronic hyperglycemia.


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