CHIEF COMPLAINT: Admission for invasive monitoring for
possible epilepsy surgery.

PRESENT ILLNESS: The patient is a 29-year-old
right-handed woman with a ten-year history of seizures.  Her
typical seizures consist of a feeling in the abdomen followed
by head shaking.  These seizures tend to occur at night.  She
has had about three to four spells per day and was started on
phenobarbital recently which decreased the seizures to about
one to two per night but she now feels drugged by the
medication.

MEDICAL HISTORY: Seizure disorder as above.

MEDICATION ON ADMISSION: 1.  Phenobarbital 190 mg q.h.s.
2.  Topamax 225 mg q.a.m., 200 mg q.p.m.
3.  Depo-Provera shot q. three months.

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Epilepsy, unspecified, with intractable epilepsy
Epilepsy NOS w intr epil
Admission Date:  [**2111-9-17**]       Discharge Date:  [**2111-10-5**]

Date of Birth:   [**2082-3-9**]       Sex:  F

Service:  NEUROMEDICINE

CHIEF COMPLAINT:  Admission for invasive monitoring for
possible epilepsy surgery.

HISTORY OF THE PRESENT ILLNESS:  The patient is a 29-year-old
right-handed woman with a ten-year history of seizures.  Her
typical seizures consist of a feeling in the abdomen followed
by head shaking.  These seizures tend to occur at night.  She
has had about three to four spells per day and was started on
phenobarbital recently which decreased the seizures to about
one to two per night but she now feels drugged by the
medication.

She had an admission in the spring of [**2110**].  Depth electrodes
revealed a right parietal focus.  She is now admitted for a
grid placement and further evaluation for possible resection
for epilepsy surgery.  Her grids were placed on the day of
admission without complication.

PAST MEDICAL HISTORY:  Seizure disorder as above.

MEDICATIONS ON ADMISSION:
1.  Phenobarbital 190 mg q.h.s.
2.  Topamax 225 mg q.a.m., 200 mg q.p.m.
3.  Depo-Provera shot q. three months.

PHYSICAL EXAMINATION ON ADMISSION:  Vital signs:  She was
afebrile.  The vital signs were stable.  She was lethargic
but arousable, status post Dilaudid.  HEENT:  Normocephalic,
atraumatic with head dressed in monitoring equipment.
Cranial nerves:  The pupils were 4 mm to 2 mm, round and
reactive to light.  The extraocular movements were full.  She
blinks to threat bilaterally.  There was no nystagmus.  Her
face was symmetric.  Tongue was midline.  On motor
examination, she had a very mild left wrist but otherwise had
full strength throughout. Sensation was intact to light touch
throughout.  Reflexes were 2+ and symmetric with flexor
plantar responses bilaterally.  Coordination was intact to
finger-nose-finger and heel-knee-shin testing.  Random
alternating movements were intact.

HOSPITAL COURSE:  The patient is a 28-year-old woman with a
history of intractable epilepsy who presents for grid
placement and possible resection for intractable epilepsy.
She was initially continued on her phenobarbital and Topamax;
however, she had no seizures initially so her phenobarbital
was discontinued.  As she continued having no seizures
despite several days of monitoring, her Topamax was also
tapered down.

She underwent cortical stimulation and was eventually tapered
to off of all of her antiepileptic drugs.  The patient
finally began having some seizures that were recordable on
[**2111-9-26**].  The telemetry was reviewed and she was
restarted on Topamax at a dose of 100 mg p.o. b.i.d. and her
localization was further confirmed.  She underwent resection
of the right angular and supramarginal gyrus on [**2111-9-30**].

Surgery was performed by Dr. [**First Name (STitle) **] and Dr. [**Last Name (STitle) 35957**] without
complications.  Her subdural grid and strips were also
removed successfully without complications.

She returned to the Neurology Service for restart of her
prior antiepileptic regimen of Topamax 225 mg p.o. q.a.m.,
200 mg p.o. q.p.m., and phenobarbital 195 mg q.h.s.  She was
put on Dilaudid for continued headaches.  She remained in
stable condition.  She was discharged to home after only one
brief recurrent seizure during the remainder of her
admission.

DISCHARGE CONDITION:  Stable.

DISCHARGE STATUS:  Discharged to home.

FOLLOW-UP:  The patient is to follow-up and have her staples
removed the Wednesday following discharge.  She will also
follow-up with both Neurosurgery and Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **].

DISCHARGE MEDICATIONS:
1.  Topamax 225 mg p.o. q.a.m., 200 mg q.p.m.
2.  Phenobarbital 195 mg p.o. q.h.s.

DISCHARGE DIAGNOSIS:
1.  Intractable epilepsy.
2.  Status post right angular and supramarginal gyrus
resection for treatment of intractable epilepsy.


               DR.[**Last Name (STitle) 35958**],[**First Name3 (LF) **] 13-140



Dictated By:[**Last Name (NamePattern1) 1203**]
MEDQUIST36

D:  [**2111-12-24**]  05:37
T:  [**2111-12-24**]  19:32
JOB#:  [**Job Number 35959**]
{'Epilepsy, unspecified, with intractable epilepsy'}


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: Admission for invasive monitoring for
possible epilepsy surgery.

PRESENT ILLNESS: The patient is a 29-year-old
right-handed woman with a ten-year history of seizures.  Her
typical seizures consist of a feeling in the abdomen followed
by head shaking.  These seizures tend to occur at night.  She
has had about three to four spells per day and was started on
phenobarbital recently which decreased the seizures to about
one to two per night but she now feels drugged by the
medication.

MEDICAL HISTORY: Seizure disorder as above.

MEDICATION ON ADMISSION: 1.  Phenobarbital 190 mg q.h.s.
2.  Topamax 225 mg q.a.m., 200 mg q.p.m.
3.  Depo-Provera shot q. three months.

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Epilepsy, unspecified, with intractable epilepsy'}
