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Seizure With Body Jerks, Eyelids And Lip Blinking. On Levera Syrup, Clobazam. No Help. Treatment?

Posted on Tue, 11 Sep 2012

Question: Hi, My 3 yr old son suffering from seizure fro last 2 yrs his active seizure after 1 yr of age with fever 2 to3 episodes come seizure with fever after then sezure come without fever after 12 to 20 day repeated more than 1 mints before attach he is crying and jerking hole body & eye & lip blinking. Diagonist: His MRI CT Scan & EEG are normal 30mint EEG 4 time repeated but normal. Treatment: Last 1.5 yrs given - Valparin 200 - 5ml x 2 time, Clobazam 5mg - 5mg x 2time, Last 5 month given : Valparin 200 - 5ml x 2 time, Clobazam 7.5mg per day in night, Levera Syrup: 3ml x 2 time. Last 5 month given : Valparin 200 - 5ml x 2 time, Clobazam 7.5mg per day in night, Zanoxa 150mg (Oxcarbazepine) 1 tab mornig & 1.5 tab in night and Levera Stop. But still no any improvement last year 4-5 month control but stil is not improvement. Please help any one hi is treated in delhi Proff Dr XXXXXXX Kalra, Appolo Hospital, Retired proff from AIIMS (Ped. Neurology) Thanks XXXXXXX- 0000

Answered by Dr. Shiva Kumar R (34 minutes later)

Hello,

Thanks for the query

Your question is a very good one and I will work on providing you with some good information and recommendations’ regarding what is going on.

Regarding the query on the management of seizures which are not responding to various medications already tried in your 3 years old son, I would like to know few more details:

1. Birth history - Any problems at the time of birth; his birth weight
2. Any history of infection or hypoglycemia after birth
3. Is there any history of epilepsy in the family?
4. History of consanguineous marriage (Marriage in relation)
5. Other problems like sudden jerks, vomiting, delayed development
6. His current mile stones achieved

Please provide me the details which will help me in providing details to you.

Awaiting your reply

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shiva Kumar R (43 hours later)

Hello Sir,

1. Birth History: Premature Normal Delivery after 7.5 month and Weight was 2kg. He was properly crying after 2 mint of delivery and very well.

2.No any infection to 4 month than he was suffered from Pneumonia fever and cold & flou and same problem repeated after six month (Pneumonia fever and cold). then he is well till 1 year.
No any history of hypoglycemia: Done test of Glucose Level & Sugar Level thought lumber puncher everything is normal this test was after done 1.25 year .

3. No any Family History

4. No Any history of Marriage in relation

5. Never

6. He is Walking, Running, Playing is very well & speaking only single word and good growth, physical.

Awaiting your reply

Thanks & Regards,
XXXXXXX
Mob.: 0000

Answered by Dr. Shiva Kumar R (16 minutes later)

Hello and Thanks for the details

Based on the information provided to me it looks he is prone to epilepsy because of the premature delivery and low birth weight. However presence of normal EEG (Electroencephalogram) and MRI (Magnetic Resonant Imaging) suggests the injury to be very mild.

Regarding the treatment he is on good dose of medications for his epilepsy. But if someone is not improving or has persistent seizures in the background of normal EEG, I personally feel it is worth doing a test called Video-EEG.

Video-EEG is an extended EEG done for 24-48 hours which has benefits like better defining the epilepsy syndrome. Treatment can be modified based on the epilepsy syndrome.

So I personally advice you to XXXXXXX Epileptologist who are specially trained in epilepsy and get the child evaluated in detail.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Shiva Kumar R (1 hour later)

Sir,

He is treated by just retired Professor Dr. XXXXXXX Kalra, Pediatrics Neurology, Development & Epilepsy, AIIMS, New Delhi. And He is currently working in Apollo Hospital, New Delhi. this link is his profile.

WWW.WWWW.WW

But I discuss to him and He suggest not any required of any EEG because till date 5 30 mint EEG done but report are normal.

So, Please suggest can i will go thought for any other opinion (Such As : Heart check UP and any other you suggest as is well.)

Thanks & Regards,
XXXXXXX

Answered by Dr. Shiva Kumar R (1 hour later)

Hello

Because the 30 min EEG is normal, long term EEG is helpful in finding the epilepsy syndrome. Other than this nothing is required at this point of time.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Shanthi.E