CHIEF COMPLAINT: 

PRESENT ILLNESS: The patient is a 55 year old
white male who with a known history of seizure disorder since
[**2109**], bulbar amyotrophic lateral sclerosis diagnosed in [**2117**],
depression, mild mental retardation, dysphagia, dysarthria,
recent forty pound weight loss over the prior five month
period, restrictive lung disease and hypertension.  He was
admitted to the trauma surgery service on [**2118-8-4**] after
having suffered a general tonic-clonic seizure and
subsequently a fall which caused multiple facial fractures as
well as a C5 vertebral fracture.  At the time of admission,
he was also found to have a low anti-epileptic medication
(Depakote) level.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Closed fracture of C5-C7 level with unspecified spinal cord injury,Amyotrophic lateral sclerosis,Other pulmonary embolism and infarction,Other convulsions,Cardiac arrest,Closed fracture of base of skull without mention of intra cranial injury, with prolonged [more than 24 hours] loss of consciousness, without return to pre-existing conscious level,Unspecified fall,Closed fracture of nasal bones,Open wound of nose, unspecified site, complicated
C5-c7 fx-cl/cord inj NOS,Amyotrophic sclerosis,Pulm embol/infarct NEC,Convulsions NEC,Cardiac arrest,Cl skl base fx-deep coma,Fall NOS,Nasal bone fx-closed,Open wnd nose NOS-compl
Admission Date: [**2118-8-5**]        Discharge Date: [**2118-8-14**]

Date of Birth:  [**2063-4-22**]        Sex:  M

Service:  Trauma service

HISTORY OF PRESENT ILLNESS:  The patient is a 55 year old
white male who with a known history of seizure disorder since
[**2109**], bulbar amyotrophic lateral sclerosis diagnosed in [**2117**],
depression, mild mental retardation, dysphagia, dysarthria,
recent forty pound weight loss over the prior five month
period, restrictive lung disease and hypertension.  He was
admitted to the trauma surgery service on [**2118-8-4**] after
having suffered a general tonic-clonic seizure and
subsequently a fall which caused multiple facial fractures as
well as a C5 vertebral fracture.  At the time of admission,
he was also found to have a low anti-epileptic medication
(Depakote) level.

The patient at the time of admission was noted to have
multiple areas of periorbital ecchymoses and a nasal
laceration.  Nose packing was in place due to his facial
injuries suffered from his fall.  He had no other remarkable
physical findings on the exam.  The patient was then also
noted to have the following admission labs:  White count
11.5, hematocrit 45.8, platelet count 294. Valproate level
was less than 3.0.

The patient also was noted to have had a CT scan of the head
and neck, which showed right sided maxillary and orbital wall
fractures, pterygoid plate fracture, and nasal fractures.
His CT of the c-spine showed a fracture at the level of C5,
and he was also noted to have a facet fracture at C5 as well.

A concise review of the [**Hospital 228**] hospital course included a
prolonged intensive care unit stay secondary to the patient's
respiratory status, poor ability to swallow on his own, and
the vertebral fracture that he suffered.  The patient was
subsequently treated with a gastrojejunal feeding tube by the
trauma surgery service, and tracheostomy by the trauma
surgery service, and he also had his C5 fracture fixated by
the orthopedic spine service.  Additionally, he had his
facial fractures repaired with the assistance of both the
oral maxillofacial service and the neurosurgical service.

The patient, after having spent most of his hospitalization
in the intensive care unit, was slowly weaned to a trach
collar and noted to be more alert, awake, and following
commands.  He was subsequently transferred to the floor, and
continued to improve until approximately [**2118-8-13**], when
he suffered a cardiac arrest in the late evening.
Resuscitation efforts included cardioversion and chemical
cardioversion, and he was stabilized with stable vital signs
and then brought to the intensive care unit for monitoring.
Shortly after resuscitative efforts, it was noted that his
pupils were fixed and dilated, and he was unresponsive to
noxious stimuli.  The patient's family was contact[**Name (NI) **] and made
aware of the patient's deterioration and present clinical
condition.  After extensive discussion with them, it was
decided that he would be placed on comfort measures only.  He
was subsequently pronounced dead at 12:29 p.m. on [**2118-8-14**].  The patient's family did agree to a postmortem
examination to further evaluate the potential causes for the
patient's demise.

DISCHARGE DIAGNOSES:
1. Multiple facial fractures.
2. Cervical spine fracture.
3. Respiratory failure requiring tracheostomy.
4. Dysphagia requiring gastrojejunal feeding tube placement.




                        [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5732**], [**MD Number(1) 5733**]

Dictated By:[**Doctor Last Name 58003**]
MEDQUIST36
D:  [**2118-12-19**] 13:44:54
T:  [**2118-12-19**] 14:29:05
Job#:  [**Job Number 101182**]
{'Closed fracture of C5-C7 level with unspecified spinal cord injury,Amyotrophic lateral sclerosis,Other pulmonary embolism and infarction,Other convulsions,Cardiac arrest,Closed fracture of base of skull without mention of intra cranial injury, with prolonged [more than 24 hours] loss of consciousness, without return to pre-existing conscious level,Unspecified fall,Closed fracture of nasal bones,Open wound of nose, unspecified site, complicated'}


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: The patient is a 55 year old
white male who with a known history of seizure disorder since
[**2109**], bulbar amyotrophic lateral sclerosis diagnosed in [**2117**],
depression, mild mental retardation, dysphagia, dysarthria,
recent forty pound weight loss over the prior five month
period, restrictive lung disease and hypertension.  He was
admitted to the trauma surgery service on [**2118-8-4**] after
having suffered a general tonic-clonic seizure and
subsequently a fall which caused multiple facial fractures as
well as a C5 vertebral fracture.  At the time of admission,
he was also found to have a low anti-epileptic medication
(Depakote) level.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Closed fracture of C5-C7 level with unspecified spinal cord injury,Amyotrophic lateral sclerosis,Other pulmonary embolism and infarction,Other convulsions,Cardiac arrest,Closed fracture of base of skull without mention of intra cranial injury, with prolonged [more than 24 hours] loss of consciousness, without return to pre-existing conscious level,Unspecified fall,Closed fracture of nasal bones,Open wound of nose, unspecified site, complicated'}
