Extract the information from the following case and write it in a paragraph form, a Medical History, Current Medications, Allergies, and Reproductive History.

A.G. is a 66-year-old female who was referred to the clinic by her primary care physician (PCP) for medication management due to increasing episodes of psychogenic seizures. Her spouse reported that there has been a noticeable increase in the frequency and intensity of these episodes, which the patient has not experienced before.

Diagnosis:

1. Primary Diagnosis:Psychogenic Non-Epileptic Seizures (ICD-10 Code: G40.9)
2. Secondary Considerations:Rule out any comorbid psychiatric conditions such as anxiety or depressive disorders.

Mental Status Examination:

• Appearance:Patient appears her stated age, dressed appropriately for the occasion. Hygiene appears adequate.
• Behavior:Cooperative, but visibly anxious during the consultation.
• Mood:Reports feeling "overwhelmed" and "distressed" about her seizures.
• Affect is anxious and occasionally tearful.
• Speech:Normal in rate and tone; responses are coherent but reflect worry regarding her condition.
• Thought Process:Logical and coherent, though there are frequent expressions of fear concerning the safety and implications of her seizures.
• Thought Content:No evident delusions or hallucinations. The patient expresses concerns about health and social implications stemming from her condition.
• Cognition:Alert and oriented to person, place, and time. Insight into her condition is present but limited.
• Memory:Intact short-term and long-term memory; able to recall relevant details about her family and medical history.
• Judgment:Fair; she acknowledges stressors related to her seizures but appears uncertain about coping strategies.

Treatment Plan:

1. Medication Management:
   • Initiate Zoloft 50 mg daily for one week, then 75 mg daily thereafter to help with anxiety or related symptoms contributing to seizures. Start Hydroxyzine 10 mg QID PRN for anxiety.
   • Educate the patient about the role of medication in managing symptoms and clarify the difference between epileptic and psychogenic seizures.
2. Psychotherapy:
   • Recommend cognitive-behavioral therapy (CBT) to address underlying psychological factors contributing to the episodes. This may help her develop coping strategies and reduce anxiety surrounding her condition.
   • Consider involving family in supportive sessions to understand her condition and offer assistance.
3. Education and Support:
   • Provide educational resources about psychogenic seizures to both the patient and her spouse. Discuss the importance of a supportive environment and strategies for managing episodes when they occur.
   • Suggest joining support groups for individuals with similar conditions to alleviate feelings of isolation.
4. Monitoring:
   • Schedule follow-up appointments every 4-6 weeks to assess the frequency and nature of seizures, adjust medication as necessary, and provide ongoing support through therapy.
5. Safety Assessment:
   • Conduct an assessment of her home environment and daily routines to ensure she has a safety plan in place for managing any potential seizure episodes, including education on how her spouse can assist if an episode occurs.

Notes:

• The patient's spouse expressed significant concern about the increase in seizures and the impact on their daily life. It is essential to address both the patient's and spouse's mental health needs during treatment.
• Encouraged open communication regarding the patient's symptoms and fears, emphasizing the importance of support and understanding from her family.

Reinforced the non-epileptic basis for her seizures and the need for continued evaluation.