This clinical case presents a 59-year-old male immigrant from India who experienced a generalized tonic-clonic seizure (GTCS).

A 59-year-old immigrant from India presents after a generalized tonic-clonic seizure that took place around an hour ago. His wife witnessed the episode, which lasted for 2 to 3 minutes. After this, he was confused for another 10 to 15 minutes. He was also incontinent of urine. No other symptoms were present. He has no medical conditions, does not drink, and denies substance abuse. An ECG, full blood count, random capillary glucose, and serum electrolytes are normal.

Key Features of the Case

1. Seizure Details:

• Type: Generalized tonic-clonic seizure (GTCS), which typically involves a loss of consciousness and convulsions affecting the entire body.

• Duration: Lasted 2 to 3 minutes, typical for GTCS, followed by a postictal state characterized by confusion lasting 10 to 15 minutes and urinary incontinence, which can occur during seizures.

2. Patient Background:

• Age: At 59 years, this patient may be at higher risk for certain seizure etiologies such as cerebrovascular accidents (strokes) or other neurological conditions, but these would need to be excluded diagnostically.

• Immigrant Status: His background might be relevant in terms of possible infectious exposures (e.g., tuberculosis, tropical infections) or socioeconomic factors that could influence his access to medical care.

3. Medical History:

• The patient has no known medical conditions and denies alcohol or substance use, reducing the likelihood of seizures due to withdrawal or substance-related issues.

4. Initial Investigations:

• Normal ECG: This is reassuring, suggesting no acute cardiac abnormalities that might contribute to the seizure.

• Normal Laboratory Tests: Normal full blood count, glucose levels, and electrolytes indicate that metabolic and systemic causes of seizures, such as hypoglycemia, hyponatremia, or infection, are less likely.