praveen kumar
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POST 1/2011 dated October 31,2011 from New Delhi ,India
1. Srijan Jha, my son, was born full term by LSCS on 1st March, 2005 and had a normal, routine neonatal resuscitation.
2. He developed recurrent convulsions since 7 days of age occurring 10-12 times/day, lasting a few seconds and investigations revealed low serum Ca+Mg with raised Po4+normal PTH sepsis screen was negative and u/s study of brain was normal. He responded well to Inj. Calcium gluc. and was put on oral supplements.Since then,his Calcium levels remained normal.
3. Again in October,2005,while passing stool he had a brief episode of 1 absence attack which was not followed up as he had just been discharged after 3 day bout of viral fever.
4. On 12th May, 2006,he again had a longer lasting attack of absence attack lasting about 3-5 minutes. This was thought as Febrile convulsions and he was investigated. It was diagnosed as febrile seizure by Dr Arijit Chattopadhyay (Paediatric neurologist) of National Neurosciences Centre, Kolkata. The prescription was on Clobazam prophylaxis-5mg b/d, with fever and advised to continue with Frisium prophylaxis for fever till age of five and give Frisium for 2-3 days max. After 5 1/2 years, as advised, we stopped Frisium prophylaxis. Whereas the MRI report of brain was normal the EEG report indicated “this sleep record is abnormal and shows possible epileptiform activity from the right temporal-parietal areas. No spread is seen”. No seizure after this episode.
5. After a gap of five and a half years, on October 8, 2011, Srijan again had seizure. Our family was coming to Delhi from Dehradun by train. We started our journey at 0515 hrs and Srijan was sleeping with his head on his mother’s lap, who was on his left, in a two seater AC Chair Car seat. Around 0540, I saw him like falling down. When he was lifted, his body was jerking/shaking, his mouth making a noise like we make in hic-ups, fists were clenched, eyes rolled up, non- responsive to name and sound. The stiffening/shaking of the right side was more as compared to the left. There was a doctor travelling in the coach, who made him lie down on his left and he advised us to let him sleep. He opined that Srijan had seizure and to consult a paediatrician. We noticed saliva (slight whitish and frothy) dripping from his mouth, after which his body became normal. However, Srijan, kept on sleeping.
6. We consulted Dr Vineet Bhushan Gupta, Consultant Paediatric Neurologist at Apollo Hospitals who put him on a two year dosage of 5 ml b/d, sodium-valporate. The sleep deprived EEG/MRI for epilepsy protocol at this time was absolutely normal.
7. In our immediate family we do not have any epilepsy patients. My wife’s cousin had febrile episodes in his childhood but is presently doing fine.
OCTOBER 21,2011: Second opinion in Delhi
• This week we went to Dr Veena Kalra, MD, Ex HOD (Paediatrics) AIIMS. She was credited with establishing specialized Paediatric neurology centre within AIIMS. She asked us to have a second EEG.
• The second EEG of Srijan held today at her clinic, showed frequent left temporal occipital spikes/S-W discharges, suggesting an abnormal EEG. She herself wrote the opinion.
• She thereafter suggested tablet ZENOXA 150 mg, 1/2 two times daily with additional Tablet CLOBA for three days during fever. She did not recommend EPILEX. She told that now it is confirmed that Srijan has epilepsy and the spikes in the left temporal region validates the extra jerk of the right side of the body. These episodes have been tabulated already.
Right now
We have started our son on Tab Zenoxa (group oxcarbazepine)150 mg, twice daily.
Regards
Praveen
1. Srijan Jha, my son, was born full term by LSCS on 1st March, 2005 and had a normal, routine neonatal resuscitation.
2. He developed recurrent convulsions since 7 days of age occurring 10-12 times/day, lasting a few seconds and investigations revealed low serum Ca+Mg with raised Po4+normal PTH sepsis screen was negative and u/s study of brain was normal. He responded well to Inj. Calcium gluc. and was put on oral supplements.Since then,his Calcium levels remained normal.
3. Again in October,2005,while passing stool he had a brief episode of 1 absence attack which was not followed up as he had just been discharged after 3 day bout of viral fever.
4. On 12th May, 2006,he again had a longer lasting attack of absence attack lasting about 3-5 minutes. This was thought as Febrile convulsions and he was investigated. It was diagnosed as febrile seizure by Dr Arijit Chattopadhyay (Paediatric neurologist) of National Neurosciences Centre, Kolkata. The prescription was on Clobazam prophylaxis-5mg b/d, with fever and advised to continue with Frisium prophylaxis for fever till age of five and give Frisium for 2-3 days max. After 5 1/2 years, as advised, we stopped Frisium prophylaxis. Whereas the MRI report of brain was normal the EEG report indicated “this sleep record is abnormal and shows possible epileptiform activity from the right temporal-parietal areas. No spread is seen”. No seizure after this episode.
5. After a gap of five and a half years, on October 8, 2011, Srijan again had seizure. Our family was coming to Delhi from Dehradun by train. We started our journey at 0515 hrs and Srijan was sleeping with his head on his mother’s lap, who was on his left, in a two seater AC Chair Car seat. Around 0540, I saw him like falling down. When he was lifted, his body was jerking/shaking, his mouth making a noise like we make in hic-ups, fists were clenched, eyes rolled up, non- responsive to name and sound. The stiffening/shaking of the right side was more as compared to the left. There was a doctor travelling in the coach, who made him lie down on his left and he advised us to let him sleep. He opined that Srijan had seizure and to consult a paediatrician. We noticed saliva (slight whitish and frothy) dripping from his mouth, after which his body became normal. However, Srijan, kept on sleeping.
6. We consulted Dr Vineet Bhushan Gupta, Consultant Paediatric Neurologist at Apollo Hospitals who put him on a two year dosage of 5 ml b/d, sodium-valporate. The sleep deprived EEG/MRI for epilepsy protocol at this time was absolutely normal.
7. In our immediate family we do not have any epilepsy patients. My wife’s cousin had febrile episodes in his childhood but is presently doing fine.
OCTOBER 21,2011: Second opinion in Delhi
• This week we went to Dr Veena Kalra, MD, Ex HOD (Paediatrics) AIIMS. She was credited with establishing specialized Paediatric neurology centre within AIIMS. She asked us to have a second EEG.
• The second EEG of Srijan held today at her clinic, showed frequent left temporal occipital spikes/S-W discharges, suggesting an abnormal EEG. She herself wrote the opinion.
• She thereafter suggested tablet ZENOXA 150 mg, 1/2 two times daily with additional Tablet CLOBA for three days during fever. She did not recommend EPILEX. She told that now it is confirmed that Srijan has epilepsy and the spikes in the left temporal region validates the extra jerk of the right side of the body. These episodes have been tabulated already.
Right now
We have started our son on Tab Zenoxa (group oxcarbazepine)150 mg, twice daily.
Regards
Praveen