CHIEF COMPLAINT: 

PRESENT ILLNESS: Mr. [**Known lastname 7716**] is a 33-year-old
man with a history of resected left pilocytic astrocytoma at
age 22 months and status post whole brain XRT.  He developed
seizures in childhood.  His seizure phenotype has been
predominantly complex partial seizure with secondary
generalization.  His most recent secondarily generalized
seizure prior to the current admission was beginning of [**2166-3-1**].

MEDICAL HISTORY: 1. Complex partial seizures as above.
2. Nephrolithiasis (presumed secondary to Topamax therapy).

MEDICATION ON ADMISSION: 1. Topamax 350 mg [**Hospital1 **].
2. Depakote 500 mg tid.
3. Trileptal 300 mg [**Hospital1 **].

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No epilepsy.

SOCIAL HISTORY: Mr. [**Known lastname 7716**] is functioning in the
community.  He was assisting in the library, and now works
for Gateway.  He lives with a roommate in an assisted-living
facility.  He does not smoke.  He does not consume alcohol.
He does not do drugs.
Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, with intractable epilepsy,Urinary tract infection, site not specified,Fall resulting in striking against other object,Accidents occurring in residential institution,Personal history of malignant neoplasm of brain,Personal history of irradiation, presenting hazards to health
Brain hem NEC-brief coma,Brain inj NEC-brief coma,Psymotr epil w intr epil,Urin tract infection NOS,Fall striking object NEC,Accid in resident instit,Hx of brain malignancy,Hx of irradiation
Admission Date:  [**2166-6-22**]       Discharge Date:  [**2166-6-30**]

Date of Birth:   [**2132-12-29**]       Sex:  M

Service:

PRINCIPAL DIAGNOSIS:  Traumatic brain injury.

ASSOCIATED DIAGNOSES:
1. Diffuse axonal injury.
2. Complex partial seizures.
3. Developmental delay.
4. Status post resection of astrocytoma.
5. Status post whole brain XRT.

HISTORY OF PRESENT ILLNESS:  Mr. [**Known lastname 7716**] is a 33-year-old
man with a history of resected left pilocytic astrocytoma at
age 22 months and status post whole brain XRT.  He developed
seizures in childhood.  His seizure phenotype has been
predominantly complex partial seizure with secondary
generalization.  His most recent secondarily generalized
seizure prior to the current admission was beginning of [**2166-3-1**].

Approximately two weeks prior to admission, he had another
generalized seizure with a prolonged postictal phase, and was
taken to [**Hospital3 1196**], where a head CT scan was
normal and he was discharged home from the Emergency Room.
At home, however, he continued to be lethargic and was
eventually brought to [**Hospital1 69**]
Emergency Department on [**2166-6-22**] for further evaluation.

Subsequent MRI shortly after admission to [**Hospital1 346**], showed blood products in both
frontal and occipital lobes and some associated T2
hyperintensity suggesting diffuse axonal injury.  He was
admitted to the Neuro-ICU, where on subsequent days, he
showed gradual recovery with progressively decreasing
lethargy.

PAST MEDICAL HISTORY:
1. Complex partial seizures as above.
2. Nephrolithiasis (presumed secondary to Topamax therapy).

MEDICATIONS ON ADMISSION:
1. Topamax 350 mg [**Hospital1 **].
2. Depakote 500 mg tid.
3. Trileptal 300 mg [**Hospital1 **].

ALLERGIES:  No known drug allergies.

FAMILY HISTORY:  No epilepsy.

SOCIAL HISTORY:  Mr. [**Known lastname 7716**] is functioning in the
community.  He was assisting in the library, and now works
for Gateway.  He lives with a roommate in an assisted-living
facility.  He does not smoke.  He does not consume alcohol.
He does not do drugs.

EXAMINATION ON ADMISSION:  Mr. [**Known lastname 7716**] was drowsy on
admission.  He responded to questions with only single words.
In-fact he only uttered yes, no, right, or [**Known firstname **].  He was
oriented to name only.  Otherwise, his pupils are equal,
round, and reactive with impaired smooth pursuit and
nystagmus and downward gaze.  His face on admission was even.
His tongue and palate were midline.  His tone was normal.
He had no tremor.  He had mild left pronator drift, but
otherwise was full power.  His left plantar reflex was
upgoing.  He was generally lethargy and uncooperative,
therefore gait and coordination were not tested on admission.

In subsequent days, Mr. [**Known lastname 7716**] showed gradual improvement.
On day of discharge, he is able to stand and walk
independently.  He has apparent full power throughout.  He is
oriented to person and hospital, although not oriented to
time.  His mental status examination is notable for shortened
attention with a digit span of [**3-4**].  There are no new motor
findings.

In short, the most notable change at time of discharge is a
change in mental status from baseline.

Mr. [**Known lastname 7716**] is being discharged to a rehabilitation, where
he can receive physical therapy, but more importantly
cognitive rehabilitation therapy for traumatic brain injury
and presumed diffuse axonal injury.

DISCHARGE MEDICATIONS:
1. Topamax 350 mg po bid.
2. Depakote 500 mg po tid.
3. Tylenol 325-650 mg po q4-6h as needed.
4. Zantac 150 mg po bid.
5. Trileptal 600 mg po bid.

ADDENDUM:  In the course of Mr. [**Known lastname 22617**] admission, urine
culture showed an E. coli urinary tract infection.  Mr.
[**Known lastname 7716**] was therefore started on Bactrim po.  He is to
continue this medication for 10 days total.  A repeat urine
culture was drawn before discharge.  Results are pending at
this time.

FOLLOW-UP INSTRUCTIONS:  Mr. [**Known lastname 7716**] is to follow with
Epilepsy at [**Hospital1 69**].
Appointment to be made before discharge.

This is a partial discharge summary to be addended on actual
day of discharge.




                            [**First Name11 (Name Pattern1) 1112**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **], M.D.  [**MD Number(1) 7499**]

Dictated By:[**Name8 (MD) 22618**]
MEDQUIST36

D:  [**2166-6-30**]  19:53
T:  [**2166-7-1**]  05:18
JOB#:  [**Job Number 22619**]
{'Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, with intractable epilepsy,Urinary tract infection, site not specified,Fall resulting in striking against other object,Accidents occurring in residential institution,Personal history of malignant neoplasm of brain,Personal history of irradiation, presenting hazards to health'}


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: Mr. [**Known lastname 7716**] is a 33-year-old
man with a history of resected left pilocytic astrocytoma at
age 22 months and status post whole brain XRT.  He developed
seizures in childhood.  His seizure phenotype has been
predominantly complex partial seizure with secondary
generalization.  His most recent secondarily generalized
seizure prior to the current admission was beginning of [**2166-3-1**].

MEDICAL HISTORY: 1. Complex partial seizures as above.
2. Nephrolithiasis (presumed secondary to Topamax therapy).

MEDICATION ON ADMISSION: 1. Topamax 350 mg [**Hospital1 **].
2. Depakote 500 mg tid.
3. Trileptal 300 mg [**Hospital1 **].

ALLERGIES: No known drug allergies.

PHYSICAL EXAM: 

FAMILY HISTORY: No epilepsy.

SOCIAL HISTORY: Mr. [**Known lastname 7716**] is functioning in the
community.  He was assisting in the library, and now works
for Gateway.  He lives with a roommate in an assisted-living
facility.  He does not smoke.  He does not consume alcohol.
He does not do drugs. 

### Response:
{'Other and unspecified intracranial hemorrhage following injury without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Intracranial injury of other and unspecified nature without mention of open intracranial wound, with brief [less than one hour] loss of consciousness,Localization-related (focal) (partial) epilepsy and epileptic syndromes with complex partial seizures, with intractable epilepsy,Urinary tract infection, site not specified,Fall resulting in striking against other object,Accidents occurring in residential institution,Personal history of malignant neoplasm of brain,Personal history of irradiation, presenting hazards to health'}
