30 year old male with an episode of seizures

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I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan. 

Chief Complaints:

Patient had an episode of seizures and lost consciousness on June 22nd night

He complained of generalised weakness since morning 

History of Presenting Illness

Daily routine of the patient: Patient wakes up at 4:30 AM and completes his daily activities. He usually does not have breakfast and then goes to work as a labourer at 7 AM. He carries heavy loads and then has a break in the afternoon.He usually does not have lunch and goes to a vegetable stall and carries loads again. He says he consumes alcohol about 90-360 mL almost every day depending on how much money he has. He comes home around 7 and has dinner and sleeps.

Patient was apparently asymptomatic 10 years ago and then he started consuming alcohol regularly. He says he experiences restlessness and sleep disturbances if he is not consuming alcohol

Sequence of events that lead to the present day:

He was not feeling well since the past 2 days and had 2 episodes of vomiting and decreased food intake. He was resting the whole day and at night he wasn’t able to sleep he got up and lost consciousness, and has no recollection of events. Patient’s attender who witnessed the episode, said the patient fell on the ground and had an episode of seizure which lasted for 5-10 minutes, tonic clonic movements of upper and lower limbs.

Past history:

He had a history of a similar episode of seizure in the past, for which he was taken to the local RMP for treatment and came home afterwards. 

Personal History:

Diet: mixed

Appetite: decreased

Sleep: experiences disturbances

Bowel and Bladder: normal

Habits: known alcoholic since 10 years.

General Examination

Patient is conscious, coherent and cooperative.

BP;30/90

PR: 86 bpm

RR: 18/min

Pallor is present. No cyanosis, clubbing koilonychia, lymphadenopathy, edema

Systemic Examination:

 CVS‐ S1 S2 heard, no murmurs

RS‐ Normal vesicular breath sounds hears

P/A - No tenderness, no palpable mass

CNS:

HIGHER MENTAL FUNCTIONS:

Conscious, coherent, cooperative

Appearence and behaviour:

Emotionally stable

Recent,immediate, remote memory intact

Speech: comprehension normal, fluency normal

CRANIAL NERVE:

All cranial nerves functions intact

SENSORY FUNCTIONS

SPINOTHALAMIC TRACT

Pain , temperature ,presure- intact in all limbs

Posterior column:

Fine touch, vibration and proprioception are intact

MOTOR SYSTEM : 

                      Right          Left

Bulk: 

Inspection.      N.              N

Palpation.        N.             N

Tone: 

UL.                  N.               N

LL.                    N.             N

REFLEXES

 

         B      T      S      K        A         P

 

R      2+     -     -       -          -         Flexor

 

L       2+     -     -       -          -         Flexor

CEREBELLUM:

Walking in a straight line:

https://youtu.be/RB3SUICBPMI

Dydiadochokinesia:

https://youtu.be/jiIm7pRE5c8

Romberg test:

https://youtu.be/V1KkckPoNhg

Investigations:

DIagnosis:

Seizures secondary to alcohol withdrawal