Baby with status epilepticus

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DanaC

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Dear everybody,
I've been reading for a while, but afraid of posting as this might make things more real and scarry. But they are real and scarry, so here I am.

I'm the mother of 17month old twin girls. They were born prematurely at 34 weeks. They were then healthy, stayed in the hospital for only 18 days to gain some more weight, keep there body temperature and learn to drink the bottle.

The smallest one, 1860g at birth, had at 13 month her fisrt seizures. During the night, while sleeping she was complaining, like something would hurt. At midnight I just woke up, looked at her and she seemed strange to me. I took het from her bed, put her on our big bed and she start seizing. I screemed for my husband, he took her, went to the leaving room, put some cold water on her face and in 2 minutes she was ok. She had fever so we start Paracetamol. We called the hospital, they accepted for us to come since it was the first seizure for her. My husband took her, the doctor checked, said it's probably an ear infection and it's simply a fever convulsion. This was bad, but we knew it could happen since my husband had fever convulsions as well, as a child. We gave another paracetamol after 6 hours (those were the rules, now we do it every 4 hours) when she also woke up. She still had fever, but looked good and wanted to play. I changed her and took her to play. Five minutes after, she just wanted to be hold, I took her in my arms and she start showing things in the house, but she would not look at me if I called. I screemed again for my husband, he took her, put her on the couch (this time we knew better, we've been reading all night long), undress her, put a wet towel on her forehead, start counting minutes. After 5 minutes I called the ambulance. She stoped seizing after 7 minutes in total. When the ambulance came, they said she is stable now and the familiy doctor should decide if she needs to be taken to the hospital. They called and made an imediate appointment, the family doctor called the pediatrician which admitted us to the hospital because she had 2 seizures in a time interval smaller than 12hours, we were told.

She stayed 2 days, they only did blood work and urine check-up, decided it's an otitis, put her on antibiotics, and we left home with the diagnostic of fever convulsions. We got Stesolid, for just in case.

Five weeks later, on a Monday morning, the same story: she wanted to be in our arms, she start pointing at things and not responding us when calling. We imediatly realized it's happening again, after 5 minutes Stesolid, waited for 2 more minutes, nothing, call ambulance. They came when she was seizing for 15 minutes already, gave oxygen, took her to ER. In there they gave another Stesolid, no reaction, Dormicum through IV, she stopped seizing after 45 minutes. Second time and status epilepticus. And no fever, so at the moment of seizure she had no fever. They checked for pneumonia, blood, urine, she had again an ear infection and some other viral infection. After 8 hours from the seizure she had high fever. Her sister had as well a viral infection, spots on the skin, etc.

Finally the neurologist was called to see if he considers she needs other tests. We told him our worries and he decided she needs EEG, MRI. In parallel they did ECG, metabolic deseases tests, and of course initial tests: glucose, electrolites, and others to find the trigger for the seizures. EEG, ECG, MRI came out ok. However, specialist said the seizure is more risky than medicine so he started her on valproic acid, 80mg a day. We were home after 5 days in the hospital and next weekend we were back again; no seizure, but high fever and because of the risks they kept her for the weekend. Otitis is again the cause of the fever, specialist says she needs an myringotomy; she got as well antibiotics. One week after myringotomy, again otitis, lots of licquids coming out, antibiotics again. No seizure. Another infection after 2 more weeks, fever, no seizure. Meet neurologist, tests the level of Depakine in blood, cames smaller than limit, however considers she's doing ok, she had other infections and fever withot seizure so he says we leave it as it is. Two more weeks, and she gets again fever. Start Paracetamol in the night, 22:00, actually withot fever because she was complaining while sleeping. At 1:00 she had fever so we gave another one, 5 again, 9 again, 10:30 she goes to sleep, wakes up after 1 hous caughing. She would usually sleep for 2 hours, so this was strange, but we said it's probably the caughing. In half an hour the same story, Stesolid, emergency, second Stesolid after half an hour in the ER, no response, IV with her daily dosage of Depakine and she stops seizing again after 45 minutes. Tests for viruses, bacterias, meningitis, pneumonia, nothing except RS virus. Her sister has is as well, caugh, running nose, but deals with it at home.

We find out that metabolic deases tests found a peak in an aminoacid, but nothing to woory,we're told, since it could be due to some medication. Since she's back in the hospital, the test are repeated, but result in begining of January. As well as results for tests on the status of her imune system.

One last thing to tell is that both times with status epilepticus there was some excitement previews 2 days (first time pool all day long, followed by visit at some friends next day, second time me coming back after a week of work related absence and lots of playing, at home this time).

Thank you for reading all that, I thought it's important to tell everything, so the story is properly understood.

I'm waiting for any info, advices, anything. It's been so hard for us, the parents, her as well in the hospital so many times with all those people in white coming to do something to her and her sister which was so sad without her. It's been hard as well when the doctor says "sensitivity towards epileptic seizures", what is that? I mean she's got twice status epilepticus. And what does it mean, why it's so severe, why it doesn't happen with all infections, but only some? And should we thing is less bad because eeg and mri were ok? We know it's maybe impossible to answer such questions, we've been reading a lot, but it's so hard to be on dark, is it going to happen again, can it worsen, will we find something to control her seizures, will it all go away as she grows up, will the medicine influence her, and so much more...

Thanks again for reading and I'm anxious on getting new friends here. Good luck to everybody, lots of health and no seizures!
 
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I cant offer any advice other than hang in there. Hopefully it will get better. The hardest part is figuring out what is wrong. AFter that it seems to get easier. Could she have a virus? allergies? SHe being so young its extra hard. I am so sorry for you all and hope this resolves itself quickly and you all are able to go about your daily life.

Please let us know how it goes.
sincerely,
joan*
 
Hi, Joan. Thanks for your thoughts.
She's been tested for viruses every time, but yet, there are so many. We've been asking about allergies, they say it must have been visable in other ways and tests show so little anyhow. She's at creche 5 days per week, so often infections are not strange, but how she behaves to them, that's a different story (we can say that, we've got 2 of them, treated the same, leaving in the same environment, and yet, one can have a fever and play and the other gets a seizure). So we're anxious on finding the status of her imune system (even if we understood that if the results are bad the tratement means 2 years of daily antibiotics is a very slow dose, not smth that we would like) and the results of metabolic tests (it could be that the trigger is not infection/fever/excitement, but some toxine which is accumulating, or whatever other problem, and the rest is coincidence, or maybe enhancing the trigger...)
In the meanwhile trying to find out what could help, she eats healthy, we make our own bread, she gets lots of fruits and vegetables, milk, cheese, eggs and meat only once per week, and as much as we can afford, organic food always. However, looks like this things don't matter. That's the hardest part, that we feel we're not in control, they tell us we're great parents, that's of no help if being so it doesn't help her...
We will visit however a homeopathic doctor as well, see what she thinks.
Thanks again and hope we all have only good news.
Dana.
 
Hi Dana, welcome to the forum. :hello:

It sounds like you are doing everything you can to find a solution for her. :mrt:
 
you are going through some very scary times. Sometimes it's hard to know what triggers a seizure. We can offer the 'usual suspects' but until all of the tests come back, it is just a guessing game.

I agree with you that there is something unusual going on as her twin sister doesn't react in the same way with similar viral bugs and enviornment. What may be the answer is that she has epilepsy and the different virus', ear infections etc may simply be lowering her threshold for seizures. That can be intermittent. My daughter just had a stomach virus and had one seizure accompany it. When she had a sinus infection over the summer, she didn't have a seizure.

I hope you get some answers soon. Warm wishes and good thoughts are with you.
 
Welcome Dana - as a mom of a child with seizures I do know the frustration that you are feeling.
One suggestion, since you seem to be on a similar crash course in learning about seizures, is make note of every small, intuitive, out of the "norm" test, indication that you see. If her see, as in the metabolic test that there is an increase... make notes. All of this information will help in some way as you continue to figure this out. Your daughter may need something ever so small that the other child does not.

May I ask when the vaccinations were given in reference to her first seizure? How many vaccines has she had so far?

As a test of nutritional changes... why not really limit breads (or those with gluten) and limit or eliminate cheeses, and cow dairy. If you can get by with rice milk or goats milk I would see if there might be a food allergy. You can go the expensive route and get an IgG test but you can also just play the elimination game. I know time is of the essence as you don't want to see your child suffer. I decided to go cold turkey with the diet but I have a teenager. She does not 100% comply but I do see positive results when we follow it.
You might check out the information on: www.dogtorj.com
he goes into detail how these foods can harm someone that can have a sensitivity to them
Also even though there is no connection with your daughter and autism, there is a connection at times with those with seizures as they are both neurological disorders.
Check out: www.stankurtz.com
He has lot of information on how nutrition plays a role in this

I hope you keep the dialog going as it can be a very scary time.
Give her plenty of hugs and I know with your determination you will find answers.
 
Hi!

Hi Dana! Welcome to CWE. What you are going through must be terrifying. Just remember that it's scary for your child too, and try to remain calm when she does have her seizure. Check out the epilepsy 101 thread in my signature. It gives some good basic info. As for why one twin is having seizures and the other other isn't...who knows. Just because she's a twin doesn't mean that she will react the same way to a virus as her twin. As to whether the seizures will get worse, I'll be honest, they might if not treated. But it sounds like you are doing everything you can. If the children are eating solid foods now, I'd take Robin's advice and try to cut out gluten and dairy products. Those are the two most common food allergies. See if the doctor will have her tested for food allergies. Also, as to the MRI's and EEG coming out normal, that's no guarantee of anything. Many of us here who have seizures have had perfectly normal MRI's and EEG's. It sounds from what you said, that the doctor suspects that your daughter has a lower seizure threshold.
To put it simply, everybody can have a seizure. For the average person, it takes quite a lot to trigger one. But for those of us with Epilepsy, it doesn't take as much. The common triggers are not getting enough sleep and being stressed out. Some people also have seizures when they're exposed to fluorescent lighting like you find in stores, or flickering lights. It sounds like your daughter's threshold was lowered due to being sick. The ear infection. That's not unusual. It also sounds like the meds were doing their job, because she didn't seize when she got an infection after starting her meds. However, she may need to have her levels adjusted. Has she gained weight? If so, she probably needs her meds upped. When I was a child, my pediatrician would up my meds only after I had a seizure. Later, as an adult, I asked my neurologist about that and he said that the more you weigh, the more meds a person needs. So when your daughter goes through growth spurts, you'll want to keep an eye on her.
I hope this helped. This is a fantastic group of people. We have parents, caregivers, spouses, as well as people with epilepsy here. So feel free to ask questions, vent, or just chime in. We can't give medical diagnoses, but we can answer your questions based on our own personal experiences. I hope your daughter is feeling better. You're not alone in this.... :)
 
first time pool all day long, followed by visit at some friends next day, second time me coming back after a week of work related absence and lots of playing, at home this time

People with epilepsy are not supposed to engage in activities that increase their breathing rate (though some with very well controlled epilepsy have no real restrictions). It sounds like she has trouble with hyperventilation, but my guess is she's too young to do that part of the EEG to say for sure. I'd definately try to redirect her when you notice she's moving around alot. I know, not easy to do with a two year especially as they even dance while watching tv. Maybe your doctor can offer some suggestions on how to handle this.



just curious, but has she ever been tested to see if she's photosensitive?

The position of her crib, a mobile overhead, walking past it to fast, approaching her while wearing the wrong patterns (contrasting colors), or the sun coming through the window could cause her problems if she is. Also be careful of christmas decorations, especially ones that blink or move. Unless you are certain she isn't photosenstive, don't wrap any holiday gifts in that shiny/reflective wrapping paper - I get a headache just from walking past the rolls of it in the store

Stress can also bring on seizures, so you might notice more at developmental milestones.

I'm thinking that with her age and the time of the year that either one of these could be more prevalent now causing her to have more seizures

The good news is that those stress and photosensitivity are more rare triggers, and more easy to outgrow than the other triggers if she does have them
 
Thank you all. I will certainly learn a lot from you as you talk from experience and that's the most valuable. I'm a researcher and I've struggeled in the past with trying to understand non-science info. However, there are so many things that doctors say "are not scientificaly proved" and yet work, so I'm changing little by little.
By the way, I leave in The Netherlands, and this country is famous for her way of dealing with medical problems only when they're severe. First, let the nature take its course. They do have great specialists, but you can't go to one on you're own.
Also my twins are fraternal twins, not identical, so there could just be the case that one has epilepsy and the other not. Especially since it's not in the familiy, so it will probably be put on her prematurity.
I will check all the links. About food allergies we've asked, they always say there should be other signs as well. Is that true? It seems strange indeed to show no sign, but directly status epilepticus. Or maybe not? Again, we can't just go and ask for a test, they simply refuse it saying there's no indication that the test is needed. And these are private hospitals, everything is private, but controlled by government as well. IgG is on my list for a while, I'll try again. Thank you.
Vaccinations... of course thare's a connection, however with the second seizure, the first status epilepticus (even if the first time, 7 minutes is also long). So this was exactly 10 days after MMR. Her sister had fever as well, some spots on her skin; she got fever hours after the seizure and a few spots as well, they disapeared the same day. Doctors here don't want to consider such a connection. They simply don't. She had all vaccination in the program here, fortunately next one is at 4 years and will think twice before that.

With lots of information and a bit of luck hope things will be better.
Dana.
 
Every time she's been in the hospital she's been on monitor for several days. Again, we asked each doctor she've seen and each time about arrhythmia or hyperventilation, they say the monitor doesn't show anything, when they listen they don't hear anything... But she hasn't done any specific tests, to be honest I don't know what type of tests they could do. If you have any advice, please let me know.
We will limit the excitment, but she's just a small child, she's so joyfull and likes everything; we wanna give them holidays at the beach or amusements park, or whatever. And we've been to the swimming pool before it first happend with no problems...
What's your experience on triggers: can it be that she's to excited and yet the seizure apeears 2 days later, or can it just build up (for example if it would have been only excitment it would still be ok, but together with infection is bad)?
Thanks again, all the best to you,
Dana.
 
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Dear Andrew,
can you tell me if/how this could be tested. I knew seizures could be triggered by lack of vit. B6, but not that this could actually mean something serious, not only an extra trigger. We've asked only once, when they were enumerating the test they've done if her level of vit. B6 was measured, they said no, because if this would be the cause, it's always visable on EEG.
From your knowledge, is that true or it was just an answer for parents with too many question?
This would be of great importance if taking anti-convulsant is ineffective.
 
By the way, I leave in The Netherlands,

Dutch Mom is another member from Holland. :)

Vaccinations... of course thare's a connection, however with the second seizure, the first status epilepticus (even if the first time, 7 minutes is also long). So this was exactly 10 days after MMR. Her sister had fever as well, some spots on her skin; she got fever hours after the seizure and a few spots as well, they disapeared the same day. Doctors here don't want to consider such a connection. They simply don't. She had all vaccination in the program here, fortunately next one is at 4 years and will think twice before that.

Vaccines and seizures discussions
 
Thank you all. I will certainly learn a lot from you as you talk from experience and that's the most valuable. I'm a researcher and I've struggeled in the past with trying to understand non-science info. However, there are so many things that doctors say "are not scientificaly proved" and yet work, so I'm changing little by little.
I too have been challenged on this, however when it is anecdotal, and you are getting it from one reliable source from here, another from over there and a third source from up there... and it all points in the same direction, I tend to follow the ideas and see if it fits my situation.

By the way, I leave in The Netherlands, and this country is famous for her way of dealing with medical problems only when they're severe. First, let the nature take its course. They do have great specialists, but you can't go to one on you're own.
This is pretty close to the way my health care is. We have to get approval to see a specialist, and we are not able to choose the ones that we want. It is the insurance companies that provided the lists. I have found many of them to be incompetent.

Also my twins are fraternal twins, not identical, so there could just be the case that one has epilepsy and the other not. Especially since it's not in the familiy, so it will probably be put on her prematurity.
The word Epilepsy only means that your daughter has had two or more seizures. There is no connection whatsoever with it being hereditary. Some make that connection, but it is my opinion that the cause is the reason that they tend to run in the family... not that "Epilepsy" does. Remember that Epilepsy is only a label. There are causes for this disorder, and you now need to find out what is causing your daughters.

I will check all the links. About food allergies we've asked, they always say there should be other signs as well. Is that true? It seems strange indeed to show no sign, but directly status epilepticus.
Or maybe not? Again, we can't just go and ask for a test, they simply refuse it saying there's no indication that the test is needed. And these are private hospitals, everything is private, but controlled by government as well. IgG is on my list for a while, I'll try again. Thank you.
My daughter was not given that test. In fact when we went to a doctor and requested testing they tested all but the important ones, or at least they did not use the tests that are currently the "respected" tests. I gather that the labs are either not knowledgeable or they are simply too expensive and the insurance will not cover it. Then the doctors won't suggest them.

You can have food sensitivities that cause seizures. There are many people that have celiac and never have any outward symptoms. There are many people that have food intolerance, but show no outward signs of it.
From what I read from others, it sometimes is the best just to do the elimination yourself, using many of the suggestions from online groups.

Vaccinations... of course thare's a connection, however with the second seizure, the first status epilepticus (even if the first time, 7 minutes is also long). So this was exactly 10 days after MMR. Her sister had fever as well, some spots on her skin; she got fever hours after the seizure and a few spots as well, they disapeared the same day. Doctors here don't want to consider such a connection. They simply don't. She had all vaccination in the program here, fortunately next one is at 4 years and will think twice before that.
Yes this is an area that the conventional medical profession does not want to go. You are not alone though and there are a growing number of knowledgeable doctors that do believe, so it is just a matter of finding one that will work with you on this.
There is a lot of information on:
www.danasview.net
You at least have the information, and you visually witnessed this happen.
You and many other moms, so the fact that the doctors don't want to believe is simply not acceptable to me any longer. My first specialist told me many things about seizures that were false. I decided to learn as much as I could so that I would be able to ask more intelligent questions. Now Rebecca's neurologist listens and is willing to do testing that is specific to the theories that I have. I think it must be difficult for them to justify just testing for everything across the board. Once you can narrow it down, I think they are more willing to listen.
There are some Yahoo groups that deal with many of these issues regarding shots, seizures, diet, etc and perhaps they can suggest doctors in your area that would be helpful to you.

With lots of information and a bit of luck hope things will be better.
Dana.
I have found this to be the only way
Hang in there
 
WELCOME DANA!!!:clap::e::clap:

I am currently 52 yrs old, my 1st seizure was due supposedly to an exposure to measles of a neighborhood child, I had no bumps, but high fever. You can read my profile. In the 50's they did not know about epilepsy like they do now. Having worked with premies in my former days, I know that it can be alarming no matter what goes wrong in the first few years. Be assured in 2008, your babies will get the best care available and we are here to be a support to you during this difficult time with your baby's seizures and your worries.

We all care here.

Keep reading and asking questions.

We all want to help each other.

So glad you are a part of our forum and now it is your home away from home too - you will find it to be a great comfort and strength and full of information and / or links to great information.

Bernard is super about links.

Praying for your baby and situation.
 
Hello and a warm welcome to you Dana,

We have a few things in common. ;)
I'm a Dutch mom too.
And, like you, I'm mom to (not indentical) twins, a boy and a girl age 5 now. They were born after 37 weeks pregnancy, both dismature (1850 and 1790 gr.) but out of the hospital within 8 and 10 days, fortunately both being very healthy.

But my elderst boy was not so fortunate. He was born (at home) after 40 weeks + 3 days pregnancy, weighing 2580 gr and ended up in the IC of the Sophia Childrens hospital on the 3th day after birth, suffering from severe hypoglycaemia. He stayed in the hospital for 6 weeks. We were so happy with a normal MRI by then. Unfortunately we've learned the hard way that an early MRI doesn't mean automaticly things are okay. :(

My boy didn't develop like a normal baby, he was active, happy and healthy, but he didn't roll over, didn't grab toys, couldn't sit by himself being one year old, didn't walk, didn't talk. He showed a serious cognitive and motoric delay in his first year and with 1,5 year old his first seizures started. It took another year untill a new MRI showed severe brain damage, scarr tissue as a result of low blood glucosis after he was born. An EEG showed epileptic activity. It took the Dutch doctors a long time to come to the conclusion he is multiple handicapped. His epilepsy developped in the Lennox Gastaut syndrome.

This must seem a nightmare story to you and I'm absolutely not suggesting this will happen to your kid. Most kids do react well on medications and when the seizures are controlled, they develop well. I do hope she will react to the valporate or perhaps a second AED.
But in case the first two meds don't help: by then you're very welcome to join our (very active) forum on www.sos-mies.nl This is a support group (members only) for parents to kids with a difficult to control epilepsy or epilepsy syndome and it is certainly the best internet support group Holland has to offer to parents at this moment.

Just being curious: in which hospital is your daughter treated and who is her neurologist? We are in the EMC Sophia KZ in Rotterdam with prof. Arts and have been with SEIN (Heemstede) and dr. Augustijn for several years. Many parents in our group have experienced the difficult, long way from a local hospital to a child neurologist in an academic hospital or epilepsy clinic.

I do know your fears and doubts, I've been there. So I hope to be able to give you some support. In case you like to 'talk' in Dutch to another Dutch mom, send me a PM and I'll send you my e-mail adress.
 
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It seems I have to start all posts with a thank you :)
you have so much information here...
Now I start to worry again for other things, most of which are worse than epilepsy. It's so funny how I keep on reading the same things over and over again before I come to think "that might be it". How do you decide on what to put on the list? Your advice that this list for the doctor should be smaller for him to accept it makes sense, but that's how you can miss exactly the one that matters...
Dutchmom, I'm sorry for your problem, I imagine how hard it has been for you, we're just begining on this road... Your story scares me, I'm wondering if Ana is developing normally? What's normal, we go to consulatie bureau, they have that list in which they have to tick things, for example at 14 month she was supossed to be able to take 3 cubes one at a time, put it one on top of eachother and than put them in a box. She did that, she got the tick. She's not walking yet, at 17 month, her twin sister start walking a month ago. We've been asking, they say no worry until 18 month, some even 2 years. She's done everything a few weeks/months later than her twin sister, but within the limits they set.
Ana's weaker than her twin sister, she's so white and seems so sensitive, but her father was exactly the same; intelectually we would say she's more advanced than her sister, she can pay more attention for a toy/game and she learns them faster (building bloks, etc.)
Now we worry for everything and it might look strange for others that we can's assess if our child is developing at the correct pace... everybody said they were premature and we should expect all milestones later but how late is too late?
We'll certainly ask again about tests for food allergies/intolerances. I wouldn't want to change her diet now, if we want to test things there should be something for the test to pick up, right? I believe they eat healthy at home, at least, but I agree that she might help from a diet. Thank you, Robin, for stressing this one more time.
During her EEG there were some flash lights, but after all the crying during the set up she's been sleeping for 20 minutes and we were not able to wake her up even. No other tests for photosensitivity :(
Thank you all and I'll keep in touch.
Dana.
 
So after the second status epilepticus the neurologist didn't order any other tests, he simply adjusted the medicine's amount. He said the problem was she didn't have enough, so she was not actually protected, like she wouldn't get any anticonvulsant. The level in her blood during the status was 20 when it should be 40-200. Two weeks before was 30 and he assumed its fluctuating in the range 30-40 so it should be ok, afterwards he said it might have been fluctuating in a lower range. Now she gets almost 3 times as much. We'll check the level in blood at the end of this week of which results we will know when we see the neurologist on 23rd...

So we were sent home with no other insight.
We don't agree, status is so dangerous, how can we wait and do nothing but adjust the level of medication?
 
Dana - this is pretty much the route that I was given. Adjusting meds and changing meds., adding Ativan if necessary. I was given no other course of action. It was after extensive research, keeping records of episodes and daily activities that I began to see patterns occur. That is how I came to find alternative therapies that have now helped my daughter on a road to health.

That is my experience. Certainly not saying it would work for all.
 
Hello Dana,

Don't worry too much (easy to say so, I know); how you describe the differences between your twins, is very common, could be my own (healthy) twins. They show simmilar differences in development and one of them always is a few weeks or a few months later. But they DO develop, in their own way and speed. Thy not to compare them to much, they're different kids, being not-identical twins the differences are normal as long as one of them is not too far behind.

When your child really is developping abnormal, you'll know for sure. You'll know before the doctors do. They can tell you not to worry, but your intuition as a mom will tell you something IS very wrong.

As far as the long time it takes to get an appointment and research done in Holland: you could consider asking to be reffered by your neurologist to the Sylvia Toth Centre. This is an institution connected to the UMC (the academic hospital in Utrecht & WKZ Wilhelmina Childrens Hospital) They do all-inn days in which they try to find neurological diagnosises and to give you an adivice for (further) treatment. A complete multidiciplinair team (neurologist, metabolic doctor, different types of therapists etc.) will research your child in just one (very busy) day. http://www.umcutrecht.nl/subsite/Sylvia-Toth-Centrum/
 
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