CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms. [**Known lastname 102960**] is a 50-year-old
woman with known seizure disorder status post partial
lobectomy and ventriculoperitoneal shunt and SIADH from
seizure medications, who presented with a seizure, which
started in the parking lot of a grocery store.  The patient
experienced her usual aura followed by the usual seizure,
left facial convulsions.  EMS was called, found patient to be
lethargic and postictal without any injury or loss of
consciousness from the seizure.  She was brought to the ED
where she had another seizure and left face twitching as well
as left leg movements were noticed.

MEDICAL HISTORY: 1. Temporal lobe epilepsy status post two lobectomies.
2. SIADH secondary to Tegretol.
3. Low back pain.
4. Depression.
5. Obsessive-compulsive disorder.
6. Status post a VP shunt.
7. Peptic ulcer disease.
8. Incontinence.
9. Absent left hip secondary to infection status post hip
removal.
10. Anemia, B12 deficiency.
11. Hypertension.
12. Osteoporosis.
13. Bilateral heel contractures.
14. Asymptomatic ASD.
15. Lower extremity edema.

MEDICATION ON ADMISSION: 1. Amoxapine 50 b.i.d.
2. Baclofen 10 q.i.d.
3. Calcium carbonate 1.25 b.i.d.
4. Ditropan 10 q.d.
5. Fluvoxamine 25 q.h.s.
6. Phenobarbital 30 and 60.
7. Fluoxetine 60 q.d.
8. Sodium chloride tablet one t.i.d.
9. Magnesium citrate q week.
10. Ibuprofen 400 t.i.d.
11. Meclizine 12.5 b.i.d.
12. Risperdal two t.i.d.
13. Tegretol XR 200/200/300.
14. Bowel medications.
15. Tylenol.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Epilepsia partialis continua, without mention of intractable epilepsy,Other disorders of neurohypophysis,Depressive disorder, not elsewhere classified,Obsessive-compulsive disorders,Presence of cerebrospinal fluid drainage device,Other vitamin B12 deficiency anemia,Unspecified essential hypertension,Osteoporosis, unspecified,Ostium secundum type atrial septal defect
Epil par cont w/o int ep,Neurohypophysis dis NEC,Depressive disorder NEC,Obsessive-compulsive dis,Ventricular shunt status,B12 defic anemia NEC,Hypertension NOS,Osteoporosis NOS,Secundum atrial sept def
Admission Date:  [**2149-8-9**]     Discharge Date:  [**2149-8-12**]

Date of Birth:   [**2098-10-28**]     Sex:  F

Service:  MICU

HISTORY OF PRESENT ILLNESS:  Ms. [**Known lastname 102960**] is a 50-year-old
woman with known seizure disorder status post partial
lobectomy and ventriculoperitoneal shunt and SIADH from
seizure medications, who presented with a seizure, which
started in the parking lot of a grocery store.  The patient
experienced her usual aura followed by the usual seizure,
left facial convulsions.  EMS was called, found patient to be
lethargic and postictal without any injury or loss of
consciousness from the seizure.  She was brought to the ED
where she had another seizure and left face twitching as well
as left leg movements were noticed.

The patient was treated with 10 mg of Valium IM.  Previous
triggers for seizures have been low sodium.  Sodium was
checked and found to be 120, and then 116, and then 118.  The
MICU was called to admit the patient for 3% normal saline and
frequent laboratory checks.  Her last seizure was [**2149-6-6**].  Recently her sodium chloride tablets were decreased
from 3 3x a day to one 3x a day.

REVIEW OF SYSTEMS:  No new pains, no shortness of breath, no
trauma secondary to seizure.

PHYSICAL EXAMINATION:  Vital signs:  Afebrile, heart rate of
84, blood pressure 116/67 with a rate of 14, and 100% on room
air.  In general, this is a frail middle-age woman in no
apparent distress, who is lethargic.  Pupils are equal,
round, and reactive to light.  Moist mucous membranes without
lesions, no JVD.  Carotids 1+ bilaterally.  Heart had a
regular, rate, and rhythm, S1 and S2, normal, no murmurs,
rubs, or gallops.  Pulmonary:  Few bibasilar crackles.
Abdomen is soft, nontender, nondistended, plus bowel sounds.
Patient had a right groin TLC placed in the Emergency Room.
Extremities:  No clubbing, cyanosis, or edema.  The left leg
shorten and externally rotated.  She has bilateral heel
contractures.  She has 1+ lower leg edema.  She is lethargic,
but easily arousable alert and oriented times three.

MEDICATIONS ON ADMISSION:
1. Amoxapine 50 b.i.d.
2. Baclofen 10 q.i.d.
3. Calcium carbonate 1.25 b.i.d.
4. Ditropan 10 q.d.
5. Fluvoxamine 25 q.h.s.
6. Phenobarbital 30 and 60.
7. Fluoxetine 60 q.d.
8. Sodium chloride tablet one t.i.d.
9. Magnesium citrate q week.
10. Ibuprofen 400 t.i.d.
11. Meclizine 12.5 b.i.d.
12. Risperdal two t.i.d.
13. Tegretol XR 200/200/300.
14. Bowel medications.
15. Tylenol.

PAST MEDICAL HISTORY:
1. Temporal lobe epilepsy status post two lobectomies.
2. SIADH secondary to Tegretol.
3. Low back pain.
4. Depression.
5. Obsessive-compulsive disorder.
6. Status post a VP shunt.
7. Peptic ulcer disease.
8. Incontinence.
9. Absent left hip secondary to infection status post hip
removal.
10. Anemia, B12 deficiency.
11. Hypertension.
12. Osteoporosis.
13. Bilateral heel contractures.
14. Asymptomatic ASD.
15. Lower extremity edema.

ALLERGIES:  No known drug allergies.

LABORATORIES ON ADMISSION:  White blood cell count 3.7,
hematocrit 32, platelets 271.  Chem-7:  Sodium 116, potassium
3.9, chloride 82, bicarb 25, BUN 11, creatinine 0.3, glucose
of 83.  Patient had a phenobarb level of 18.2 and Tegretol
level of 4.3.  Urinalysis showed a specific gravity of 1.011,
trace ketones, all else negative.  Her urine osms were 526.

SUMMARY OF HOSPITAL COURSE BY PROBLEM:
1. Hyponatremia likely secondary to decreased salt intake
given recent decrease in salt tablet regimen.  Patient was
placed on fluid restriction of less than 800 cc/day and was
administered 3% hypertonic saline at 50 cc an hour.  Her
urine electrolytes and urine osms and sodium were checked
every 1-2 hours.  Her sodium increased from 118 to 127, then
122, 121, and 120, and then stabilized around 130, 132 on her
second day of admission.  The 3% sodium was discontinued.
The patient was continued on a 1 liter fluid restriction and
her salt tablets were started at three tablets 3x a day.

2. Seizures:  After initial ED admission, the patient had no
other seizures while hospitalized.  We continued her
phenobarbital and Tegretol at preadmission doses.  Phenobarb
and Tegretol levels were checked, and were within range.

3. Depression/psychiatric illness:  Patient's current
medications of Risperdal, amoxapine, and fluvoxamine were
continued during this hospitalization.

4. Osteoarthritis and pain:  Patient was continued on
ibuprofen, Tylenol, and Percocet during the course of her
hospitalization.

5. FEN/GI:  Patient was fluid restricted to 800 cc during her
hospitalization.  She took a regular diet.  She will continue
fluid restriction at 1 liter after hospitalization.

6. Prophylaxis:  The patient received Pepcid and subcutaneous
Heparin while hospitalized for GI and DVT prophylaxis.

7. Code status:  The patient is full code.

8. Access:  A right femoral line was placed in the Emergency
Department for administration of 3% normal saline.  The line
was pulled prior to discharge.

9. Communication:  Communication was with patient's brother,
[**Name (NI) **].

CONDITION ON DISCHARGE:  Good.

DISCHARGE STATUS:  Home with regular PCA visits.

DISCHARGE DIAGNOSES:
1. Hyponatremia.
2. Syndrome of inappropriate secretion of antidiuretic
hormone.
3. Seizure disorder.

DISCHARGE MEDICATIONS:
1. Amoxapine 50 mg b.i.d.
2. Baclofen 10 mg q.i.d.
3. Calcium carbonate 1.25 grams b.i.d.
4. Ditropan XL 10 mg q.d.
5. Fluvoxamine 25 mg q.h.s.
6. Phenobarbital 30/30/60.
7. Fluoxetine 60 mg q.d.
8. Sodium chloride tablets three tablets t.i.d.
9. Magnesium citrate q week.
10. Ibuprofen 400 mg t.i.d.
11. Meclizine 12.5 mg b.i.d.
12. Risperdal 2 mg t.i.d.
13. Tegretol XR 200/200/300.
14. Tylenol 325-650 mg q.4-6h. prn.

FOLLOW-UP PLANS:  Patient will follow up with regular PCP
provider, [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] and patient was given the number for Dr.
[**Last Name (STitle) 1366**] of Nephrology to followup regarding SIADH and
hyponatremia.



                          [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 8037**], M.D.  [**MD Number(2) 8038**]

Dictated By:[**Last Name (NamePattern1) 2706**]

MEDQUIST36

D:  [**2149-8-11**]  12:33
T:  [**2149-8-13**]  05:26
JOB#:  [**Job Number 102965**]
{'Epilepsia partialis continua, without mention of intractable epilepsy,Other disorders of neurohypophysis,Depressive disorder, not elsewhere classified,Obsessive-compulsive disorders,Presence of cerebrospinal fluid drainage device,Other vitamin B12 deficiency anemia,Unspecified essential hypertension,Osteoporosis, unspecified,Ostium secundum type atrial septal defect'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: Ms. [**Known lastname 102960**] is a 50-year-old
woman with known seizure disorder status post partial
lobectomy and ventriculoperitoneal shunt and SIADH from
seizure medications, who presented with a seizure, which
started in the parking lot of a grocery store.  The patient
experienced her usual aura followed by the usual seizure,
left facial convulsions.  EMS was called, found patient to be
lethargic and postictal without any injury or loss of
consciousness from the seizure.  She was brought to the ED
where she had another seizure and left face twitching as well
as left leg movements were noticed.

MEDICAL HISTORY: 1. Temporal lobe epilepsy status post two lobectomies.
2. SIADH secondary to Tegretol.
3. Low back pain.
4. Depression.
5. Obsessive-compulsive disorder.
6. Status post a VP shunt.
7. Peptic ulcer disease.
8. Incontinence.
9. Absent left hip secondary to infection status post hip
removal.
10. Anemia, B12 deficiency.
11. Hypertension.
12. Osteoporosis.
13. Bilateral heel contractures.
14. Asymptomatic ASD.
15. Lower extremity edema.

MEDICATION ON ADMISSION: 1. Amoxapine 50 b.i.d.
2. Baclofen 10 q.i.d.
3. Calcium carbonate 1.25 b.i.d.
4. Ditropan 10 q.d.
5. Fluvoxamine 25 q.h.s.
6. Phenobarbital 30 and 60.
7. Fluoxetine 60 q.d.
8. Sodium chloride tablet one t.i.d.
9. Magnesium citrate q week.
10. Ibuprofen 400 t.i.d.
11. Meclizine 12.5 b.i.d.
12. Risperdal two t.i.d.
13. Tegretol XR 200/200/300.
14. Bowel medications.
15. Tylenol.

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Epilepsia partialis continua, without mention of intractable epilepsy,Other disorders of neurohypophysis,Depressive disorder, not elsewhere classified,Obsessive-compulsive disorders,Presence of cerebrospinal fluid drainage device,Other vitamin B12 deficiency anemia,Unspecified essential hypertension,Osteoporosis, unspecified,Ostium secundum type atrial septal defect'}
