Jorge V. is a 27-year-old Mexican male who has recently immigrated to the U.S. He presents at the local public health clinics with a 2-year history of seizures.
The patient noted his first episode when he was living in San Luis Potosi, Mexico. A typical seizure is preceded by an occipital headache. He then loses consciousness for approximately 5 minutes while experiencing tonic-clonic motions of his left arm and leg. The episode is then followed by a period of drowsiness lasting 30-60 minutes.
The seizures were occurring at a rate of one to three times per week. He sought medical assistance from a physician in his home town. He was empirically started on phenytoin and carbamazepine. This combination of medications effectively controlled his c onvulsions. However, the patient was unable to afford any diagnostic studies. He has occasionally run out of medication and experienced reoccurrences of his initial symptoms.
Family and Social History: The patient completed third grade, but is illiterate in Spanish, and is unable to speak English. He formerly worked as a house framer. After a six-month period of unemployment in Mexico, he illegally immigrated to Houston wit h his brother. He has been living in the U.S. for the past two months and shares a 2-bedroom apartment with eight other immigrants.
Mr. V. is now employed as a temporary day laborer at a rate of $2.50 per hour. He is unmarried and has no children. No other persons in his family have a history of a seizure disorder. He occasionally drinks a quart of beer on the weekend, but denies a ny history of substance abuse.