A 30 year old male with b/l involuntary movements of hands
A 30 year old male came to casualty with c/o involuntary movements of hands and tingling and numbness in upper limbs and abdomen since yesterday morning Patient was apparently asymptomatic 20 days back then he developed fever insidious in onset, gradually progressive, low grade , intermittent not associated with chills and rigors and relieved by medication He has a history of 4-5 episodes of vomitings 5 days back. Watery, non bilious ,non projectile, with food particles as contents. Relieved by medication (unknown) No c/o pain abdomen, loose stools c/o burning micturition 2 days back, relieved now H/o similar complaints in the past(7 years back) (hypokalemiac periodic paresis) No h/o DM,HTN, asthma, epilepsy,cad, thyroid disorders He used to take alcohol occasionally for the past 10 years and stopped taking 1 month back He takes betel leaf(pan) once in 2 days for the past 10 years O/E Patient is conscious, coherent and cooperative well oriented to time ,place and person No signs