CURRENT MEDICATIONS: Topamax 300 mg. b.i.d.

Phenobarbital 130 mg daily

Sinemet 10/100 t.i.d.

Carnitor 1650 mgs. q.i.d.

JESSICA BACCUS

PARENTS:Jack and Jill Smith

1234 Hill Street

Watertown, Michigan 48067

(800) 372-7368

DRUG ALLERGIES: Valproic Acid, Aspirin

DATE OF BIRTH:08/11/75

DIAGNOSIS:3 Methylglutaconic Aciduria [Carnitor-responsive]

Epilepsy - Generalized Seizures

Parkinsonism

FAMILY HISTORY:Maternal great-grandmother following head injury in early thirties leading to seizures. Maternal aunt had fainting spells at 7 months until 17 months; given some medication.

PRENATAL HISTORY:Spotting in first trimester, nausea treated with Bendictine.

LABOR & DELIVERY:Delivered with forceps after 6 hours of labor.

Apgar 9/10.

NEONATAL HISTORY:Delivered at 40 weeks gestation. Weight 7 lbs. 6 oz.;

20 inches long; head circumference 13 inches. A peak bilirubin of 19 was obtained on the 4th day of life which

was treated with phototherapy. ABO incompatibility noted.

DEVELOPMENTAL Reached milestones appropriately until about age 1.

MILESTONES:Some regression noted between 1-2 years of age.

At 2-3 years it seemed to level off.

IMMUNIZATIONS:Had all immunizations up until school age.

COMMUNICABLE Had chicken pox in April, 1985.

DISEASES:

ALLERGIES:Saw allergist at age 6. Was diagnosed as

allergic to trees, weed, mold, and grass. Was

given injections 2 times per week for 6-9 months,

then it was stopped.

MEDICAL HISTORY/

HOSPITALIZATION:07/76 - First grand mal seizure associated with

fever. No treatment at that time.

01/77 - Admitted for dehydration.

07/77 - Admitted for neuro work up.

10/83 - Admitted again for a neuro work up.

01/84 - Gastroenteritis (Reyes like symptoms).

1986 - Ears drained.

01/88 - Hysterectomy and respiratory arrest

05/90 - University of Pittsburgh for neuro work up.

06/90 - Admitted for dehydration (has had pneumonia twice).

12/90 - Muscle Biopsy - Mitrochondrial Assay

03/92 - Admitted for chest pain to rule out myocardial

Assay.

03/92 - Admitted for chest pain to rule out myocardial

infarction.

03/95 - Admitted for neuro work up. ACTH introduced.

11/95 - Admitted with Basal skull fracture.

09/96 - Removal of breast fibroid adenoma

10/98 - Removal of breast fibroid adenoma

05/99 – Vagus Nerve Stimulator

PREVIOUS Ritalin, Melleril, Depakene, Depakote, Dilantin, ACTH,

MEDICATIONS:Tegretol, Zarontin,Phenobarbital, Meberal,

Diamox, Mysoline, Primidone, Klonopin, Valium,

Birth Control Pills, Carnitor, Mogadon, Transxene, Thiamin, Biotin, Riboflavin, Neurontin, Sinamet, and many antibotics.

DIET:Requires low fat diet.

INSURANCE Blue Cross/Blue Shield

INFORMATION:Policy #