65 M with recurrent cva , dka

55 year old male cattle rearer by occupation was brought to the casualty with complaints of Inability to move left sided upper and lower limb since 6 days
Inability to speak since morning

Patient was apparently asymptomatic 6 days back then he developed weakness of left upper and lowerlimb after waking up from sleep
For which he was taken to hospital and diagnosed to have multiple infarcts in.......areas
and was treated for the same 
During the stay patient developed ? episodes of seizure
Lasted for 10 min , ?focal , post ictal confusion for 15min 

Later patient was discharged 

Yesterday night patient had an episode of seizure , focal tonic clonic involving left upperlimb for 5minutes , gained consciousness after 10 minutes 


Later patient was unable to speak

Patient was brought to the hospital 




Past- K/C/O Dm since 5 years (under irregular medication)
Had left index finger amputated( ? Due to diabetes)

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