CHIEF COMPLAINT: Left Upper Extremity Weakness

PRESENT ILLNESS: 49F was at work in doctor's office earlier today, was unable to
move left hand and then felt tingling over her whole body.  Next
she remembers waking in hospital.  At OSH, she had second
witnessed seizure.  She was given ativan, dilantin, decadron.
CT revealed 2x3 cm right frontal mass and she was transfrerred
here for further evaluation and treatment. Upon questioning does
endorse mild right frontal headache for couple days.  Denies
visual changes, weakness, nausea, vomiting.

MEDICAL HISTORY: occassional oral herpes

MEDICATION ON ADMISSION: asa 81 takes occasionally

ALLERGIES: Sulfa (Sulfonamide Antibiotics) / Moxifloxacin / Minocycline /
Penicillins / Bactrim

PHYSICAL EXAM: Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:[**7-7**]    EOMs full with left lateral gaze nystagmus
Neck: Supple.
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: paternal grandfather died of lung ca father had MI, still
living; brother IDDM

SOCIAL HISTORY: married, has daughter and 2 step-daughters. smokes 1/2ppd x 30
yrs and social EtOH.
Other convulsions,Facial weakness,Urinary incontinence, unspecified,Other musculoskeletal symptoms referable to limbs,Unspecified condition of brain,Other isolated or specific phobias,Tobacco use disorder,Asymptomatic postmenopausal status (age-related) (natural),Personal history of allergy to sulfonamides
Convulsions NEC,Facial weakness,Urinary incontinence NOS,Muscskel sympt limb NEC,Brain condition NOS,Isolated/spec phobia NEC,Tobacco use disorder,Asympt postmeno status,Hx-sulfonamides allergy
Admission Date:  [**2198-1-24**]              Discharge Date:   [**2198-1-25**]

Date of Birth:  [**2148-9-25**]             Sex:   F

Service: NEUROSURGERY

Allergies:
Sulfa (Sulfonamide Antibiotics) / Moxifloxacin / Minocycline /
Penicillins / Bactrim

Attending:[**First Name3 (LF) 1835**]
Chief Complaint:
Left Upper Extremity Weakness

Major Surgical or Invasive Procedure:
None


History of Present Illness:
49F was at work in doctor's office earlier today, was unable to
move left hand and then felt tingling over her whole body.  Next
she remembers waking in hospital.  At OSH, she had second
witnessed seizure.  She was given ativan, dilantin, decadron.
CT revealed 2x3 cm right frontal mass and she was transfrerred
here for further evaluation and treatment. Upon questioning does
endorse mild right frontal headache for couple days.  Denies
visual changes, weakness, nausea, vomiting.


Past Medical History:
occassional oral herpes


Social History:
married, has daughter and 2 step-daughters. smokes 1/2ppd x 30
yrs and social EtOH.


Family History:
paternal grandfather died of lung ca father had MI, still
living; brother IDDM


Physical Exam:
Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:[**7-7**]    EOMs full with left lateral gaze nystagmus
Neck: Supple.
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

Cranial Nerves:
I: Not tested
II: Pupils equally round and reactive to light, 6to4
mm bilaterally. Visual fields are full to confrontation.
III, IV, VI: Extraocular movements intact bilaterally without
nystagmus.
V, VII: Facial strength and sensation intact and symmetric.
VIII: Hearing intact to voice.
IX, X: Palatal elevation symmetrical.
[**Doctor First Name 81**]: Sternocleidomastoid and trapezius normal bilaterally.
XII: Tongue midline without fasciculations.

Motor: Normal bulk and tone bilaterally. No abnormal movements,
tremors. L UE [**Doctor First Name **] 4+/5, tri [**6-7**], [**Hospital1 **] [**5-8**], grip 4+/5. Strength
full
power [**6-7**] RUE and B LE.Right pronator drift

Sensation: Intact to light touch bilaterally.

Toes downgoing bilaterally

Coordination: normal on finger-nose-finger, rapid alternating
movements, heel to shin

At Discharge: LUE weakness in bicep tricep and grip [**5-8**] delt
4+/5, o/w nonfocal


Pertinent Results:
[**1-25**] CT TORSO: no malignancy, read not finalized

[**1-25**] MRI BRAIN: Right Sided Dural based lesion, read not
finalized

Brief Hospital Course:
Pt admitted to the ICU for close neurological monitoring. She
was continued on dilantin and decadron. A CT torso and MRI brain
were requested to further evaluate her lesion and to rule out
metastatic disease.
On [**1-25**] after remaining stable, she was cleared for transfer to
the floor. She was stable on the floor and on the evening of
[**1-25**] she was deemed fit for discharge to home without services.
 She will return electively for resection of her right frontal
lesion.

Medications on Admission:
asa 81 takes occasionally


Discharge Medications:
1. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6
hours) as needed for fever,headache.
2. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
Disp:*60 Capsule(s)* Refills:*0*
3. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO
Q4H (every 4 hours) as needed for pain.
Disp:*30 Tablet(s)* Refills:*0*
4. phenytoin sodium extended 100 mg Capsule Sig: One (1) Capsule
PO TID (3 times a day).
Disp:*90 Capsule(s)* Refills:*2*
5. dexamethasone 2 mg Tablet Sig: One (1) Tablet PO Q8H (every 8
hours).
Disp:*45 Tablet(s)* Refills:*0*


Discharge Disposition:
Home

Discharge Diagnosis:
Right Frontal Brain Lesion


Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.


Discharge Instructions:
General Instructions

??????	Take your pain medicine as prescribed.
??????	Exercise should be as tolerated.
??????	You may shower
??????	Increase your intake of fluids and fiber, as narcotic pain
medicine can cause constipation. We generally recommend taking
an over the counter stool softener, such as Docusate (Colace)
while taking narcotic pain medication.
??????	Unless directed by your doctor, do not take any
anti-inflammatory medicines such as Motrin, Aspirin, Advil, and
Ibuprofen etc.
??????	You should refrain from driving at this time.

Followup Instructions:
You will receive a phone call from our office regarding
scheduling of your surgery.  if you have any questiosn before
that time please do not hesitate to call us at [**Telephone/Fax (1) 1669**]



Completed by:[**2198-1-25**]
{'Other convulsions,Facial weakness,Urinary incontinence, unspecified,Other musculoskeletal symptoms referable to limbs,Unspecified condition of brain,Other isolated or specific phobias,Tobacco use disorder,Asymptomatic postmenopausal status (age-related) (natural),Personal history of allergy to sulfonamides'}


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: Left Upper Extremity Weakness

PRESENT ILLNESS: 49F was at work in doctor's office earlier today, was unable to
move left hand and then felt tingling over her whole body.  Next
she remembers waking in hospital.  At OSH, she had second
witnessed seizure.  She was given ativan, dilantin, decadron.
CT revealed 2x3 cm right frontal mass and she was transfrerred
here for further evaluation and treatment. Upon questioning does
endorse mild right frontal headache for couple days.  Denies
visual changes, weakness, nausea, vomiting.

MEDICAL HISTORY: occassional oral herpes

MEDICATION ON ADMISSION: asa 81 takes occasionally

ALLERGIES: Sulfa (Sulfonamide Antibiotics) / Moxifloxacin / Minocycline /
Penicillins / Bactrim

PHYSICAL EXAM: Gen: WD/WN, comfortable, NAD.
HEENT: Pupils:[**7-7**]    EOMs full with left lateral gaze nystagmus
Neck: Supple.
Extrem: Warm and well-perfused.
Neuro:
Mental status: Awake and alert, cooperative with exam, normal
affect.
Orientation: Oriented to person, place, and date.
Language: Speech fluent with good comprehension and repetition.
Naming intact. No dysarthria or paraphasic errors.

FAMILY HISTORY: paternal grandfather died of lung ca father had MI, still
living; brother IDDM

SOCIAL HISTORY: married, has daughter and 2 step-daughters. smokes 1/2ppd x 30
yrs and social EtOH. 

### Response:
{'Other convulsions,Facial weakness,Urinary incontinence, unspecified,Other musculoskeletal symptoms referable to limbs,Unspecified condition of brain,Other isolated or specific phobias,Tobacco use disorder,Asymptomatic postmenopausal status (age-related) (natural),Personal history of allergy to sulfonamides'}
