Monday, May 12, 2008

communication with a patient's father

Patient's father


Tonic- Clonic Seizures

My 8-month old son has a tonic-clonic seizures attacking almost everyday (averaging 20 shouts per day). He is not able to raise his head. Is this curable? Until when my son will suffer?

We spent too much for his treatment, but to no avail.

Manish (myself) -

fits in child hood

Please get an EEG done and preferably an MRI as well. If u can't afford MRI please get at least CT scan of brain done.
Fits in child hood if associated with fever alone is nothing to worry or else we should not ignore it.
Waiting for ur reply-
Dr. Manish Kumar

Patient's father


Thanks Dr. Manish

My baby undergo the following:
1. New-born Screening : Normal
2. EEG : Tonic-Clonic Seizures
3. CT Scan : Normal
4. MRI is scheduled few months

Dr. Manish, let me make it clearer as to what really the case of my baby all about for your further analysis:

1. Both families (mine and my wife's) doesn't have any history of Epilepsy or the like.
2. This happen 5 days after they left in the Hospital (he was about 12 days old).
3. New born screen test says "Negative" to any disease.
4. 2 weeks after the incident, we consult a doctor (pedia-neuro)
5. My baby undergo EEG...and the diagnose was "Tonic-Clonic Seizures"
6. The said doctor, was the only pedia-neuro doctor in our province/island.
7. We take second opinion from other pedia-neuro doctor across the sea.
8. The advise was the same, so we decided to stick on our doctor to avoid extra expenses.
9. Presently, he is taking these medicines:
- Topamax (Topiramate)
- Rivic Acid (Anti-Convulsant)
- Otril
- Macrobeetlysine Syrup
- Depakine Syrup
10. We are visiting the said doctor every month or twice a month depending on the attacks.
11. There is a development (i.e attacks occurs less frequent)

My concern no is: Can my baby has a chance to live a normal life (even attacks occur) since until now, he can not raise his head, he don't know how to swallow foods/milk, he moves rarely when he is awake (but his eyes transfer from one place to another faster than normal). We are also wondering why when he is asleep, he seems to be normal : He is stretching his body and laughs (both he can't do when awake).

Correction

Result for EEG : Multi focal Sharps

Manish (myself) -


going further

EEG has made it clear that ur baby needs treatment. MRI will put the final nail. few conditions can be corrected surgically and baby will be free from medications. but i think instead of firing in air we should wait for MRI pictures. MRI should be done with EPILEPSY PROTOCOL or else it will not be useful. please send me pics, comment by radiologist doesn't satisfy neurosurgeons like me.
please keep in touch anyway.
Dr. Manish Kumar

Patient's father

EEG reading is abnormal due to the presence of rare multi focal sharps from both temporo-occipital areas and fronto-central areas.
There is no MRI in our area at present.

Manish kumar wrote:
hello, medications are ok. u may need to increase the dose if seizure reccurs. sorry i did not know that philipines doesn't have MRI! in india we have one on every corner! well thats not "the" investigation. If its there its better (JUST TO SATISFY HIM). Most of the gross anatomical abnormalities can be seen by CT. But if u don't have MRI till date means u don't have neurosurgeon who can use it for epilepsy surgery minimum for next 10 years. That leaves u with no choice but to continue the medications. I hope and wish ur baby comes around.
thanks
Dr. Manish

Patient's father

wrote:

Dr. Manish,
In the Philippines, MRI is also available. What I mean is, in our province/Island it will be available by mid of this year. Have to check if there's any neorusurgeon in our province (24hrs ship travel to manila). Since we don't have much resources for now, me & my wife decided to wait until june, hopefully. Dr. Manish, is my baby's disease curable? or shall he suffer for the rest of his life?

Manish Kumar wrote:
hello,
first of all sorry for my earlier observation about MRI. If MRI shows any surgicaly excisable lesion, probably we can make the baby free of medications. If no, then it remains a matter of chance- if the baby remains seizure free with the present medications for 3 years- under medical supervision- you can reduce the medications and wishfully it can be stoped one day.
I mean to say, it might be a curable disease. Lets wait for the MRI/ control of seizures.
Dr. Manish

Patient's father


Thank you Dr. Manish, you gave us Hope! We will wait for the MRI result and will forward the same to you..Thank you really...May God Bless you and your Family.

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