tokens: 412141256 FIH 3833231 39626/6vf7 817292 10/3/1994 12:00:00 AM Discharge Summary Unsigned DIS Report Status : Unsigned ADMISSION DATE : 10-03-94 DISCHARGE DATE : 10-06-94 HISTORY OF PRESENT ILLNESS : This 85 year old man was admitted because of the new onset of focal left-sided seizure and unresponsiveness . He had a past history of ischemic cardiomyopathy with an ejection fraction of 10 , mild aortic stenosis and a right middle cerebral artery territory stroke in 07/94 . He was at Orlak on the day of admission and was found unresponsive with left tonic-clonic movements , greater in the arms than in the legs . He was transferred to Fairm of Ijordcompmac Hospital , where seizures were stopped with 2 mg of Ativan . He was loaded with IV Dilantin . He remained unresponsive with poor airway protection . PHYSICAL EXAMINATION : Eyes were deviated to the left . He was flaccid bilaterally . He had no oculocephalic reflexes . After one hour his eyes were midline and he remained unresponsive . HOSPITAL COURSE : By the patient and his family &apos;s prior wishes , the patient was extubated . An electroencephalogram revealed generalized slowing without ictal events . He had no carotid bruits . He had stertorous breathing , positional tremors of the left upper extremity , a spastic left hemiparesis in flexion . He withdrew both legs to painful stimuli . The right upper extremity was flaccid and paresthetic . Again , comfort measures only were undertaken as per the patient &apos;s previous wishes and the family &apos;s current insistence . At 1:15 PM on 10/06/94 , the patient was found unresponsive with no heart sounds , carotid pulse , respiratory excursions , or pupillary reactions . His family was notified . Consent for autopsy was denied . DISCHARGE DIAGNOSIS : 1. Left middle cerebral artery territory cerebral infarction . 2. Cardiomyopathy . 3. Residual of previous right middle cerebral artery stroke . RE RHALTFETHFONGPOCE , M.D. TR : cnm / bmot DD : 10-18-94 TD : 10/19/94 CC :