70 year old male came to casualty with seizure attack

This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.
This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.
I have 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 diagnosis and treatment plan
The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omission of information that was requested to be omitt. 
A 70 yr old male, farmer by occupation presented to the casualty with chief complaints of two episodes of seizures since today morning. 
patient was apparently asymptomatic till one day ago then he developed 2 episodes of seizures did not gain consciousness in between the episodes. The seizures were associated with clenching of fists, tongue bite, postictal confusion and involuntary micturition
No H/O involuntary defecation
No H/O fever,vomiting
Diagnosed as PCA stroke 8 months back
K/C/O Epilepsy since 4 months
Last episode 4 months back with similar complaint was admitted in our hospital(not on regular medications because of lack of knowledge about medications)
K/C/O Diabetes mellitus and Hypertension since 4 months(regularly on medications)

General examination:
No pallor
No icterus  
No cyanosis 
No clubbing 
No generalized oedema

Vitals:  
On admission 
GCS:E2V1M5 (score 8)
Temp: afebrile
PR: 98BPM
RR: 18Cycles per min 
BP: 160/80 mmhg 
Spo2: 95

       Systemic examination:

CVS examination:
No visible pulsations, scars, engorged veins. 
No rise in JVP
Apex beat is felt at 5 ics medial to mid clavicular line. 
S1 S2 heard . No murmurs.

Respiratory system examination : 
Shape of chest is elliptical, B/L symmetrical.
Trachea is central. 
Expansion of chest is symmetrical
 Bilateral Airway E +

Per abdomen examination:
No visible pulsations and scars swellings.
Soft, non tender, no organo megaley.
Umbilicus is inverted. 

CNS EXAMINATION:

1. HIGHER MENTAL FUNCTIONS:
   Level of consciousness:stuporous
    Speech-no response

2.CRANIAL NERVES: INTACT

3.MOTOR
            Tone                      Right          Left
                    Upper limb.  Increased   N
                    Lower limb       N              N
         Reflexes:                Right            Left. 
              Biceps.                     ++          ++
              Triceps.                    ++          ++
              Supinator.                ++           ++
              Knee.                         -              -
              Ankle.                        -              +

5.CEREBELLAR signs :
        Finger-nose coordination-no
        Knee-heel coordination-no

6.ANS: Normal

7.Meningial signs: NO

8.Spine, cranium, peripheral nerves: Normal

Diagnosis: GTCS Secondary to ?old PCA stroke

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