Concluded Case

FOCAL SEIZURES

4 years old male child CHIEF COMPLAINTS - Patents give history of child having focal convulsions one sided upper limb HISTORY OF PRESENT ILLNESS- While sleeping during early morning- parents noticed focal convulsions of upper limb - one side only Lasted for 1 minutes- followed by loss of consciousness for 5 minutes .There after he was normal and do not recollect the events No vomitings. NO fever or any other illness INVESTIGATIONS DONE- 1.MRI BRAIN - NORMAL 2EEG - DYS 3 RIGHT FRONTAL SPIKES WITH FOCAL EPILEPTIFORM ABNORMALITIES OVER RIGHT FRONTAL REGION DIAGNOSIS AND TREATMENT?

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Simple focal epilepsy or petitmal epilepsy focal in origion. Sodium valproate 10mg/kg bd.for at least 3yrs. Review after 3yrs.stop if seizure free interval is yr.if persist then life long continue it.

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Focal onset of Seizure.. The human brain works by sending electrical signals through neurons, which are nerve cells. A seizure occurs when there’s a surge in this electrical activity. This causes a host of physical symptoms, such as muscle contractions, visual disturbances, and blackouts. Seizures can affect the entire brain.  Two of the most commonly used medicines to treat partial seizures are Carbamazepine and Lamotrigine .Other choices include Valproate .... Oxcarbazepine , Gabapentin (Neurontin) and Topiramate .

Clear history of Focal seizures of Upper limb f/b loss of consciousness and post ictal confusion.... EEG also is normal Clear indication to start anti epileptics and keep the patient in follow up

Right focal epileptiform focus with left upper limb focal seizures ,followed by loss of consciousness. MRI normal . Likely to have family history . Need to enquire about natal history- did the child cry immediately after delivery, was there cyanosis , APGAR score . Did the child have post ictal Todd's palsy ? Was there fever during this episode ? Neuro opinion. Levipiracitam 250 mg 1/2 BD Check metabolic parameters .

Thank you,Doctor
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What about physical exam findings?. The history and EEG abnormality suggestive focal epilepsy from the Rt frontal area. Side of focal fit is not mentioned.. Single episode of focal fit with rt frontal epileptic focus. Suggest

EEG suggesting rt frontal lobe spikes suggest focal epilepsy a/w loss of consciousness these are epileptic episodes only Levitracetam 500mg 1od can be titred upto tds doses

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Simple focal epilepsy or petitmal epilepsy focal in origion. Sodium valproate 10mg/kg bd.for at least 3yrs. Review after 3yrs.stop if seizure free interval is yr.if persist then life long continue it.

? PARTIAL .. SEIZURES.. NEED'S.. NEUROLOGICAL EVALUATION WITH EXPERTS OPINION..

Tnx Dr Vipin Bihari Jain
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Focal seizure Sodium Valproate 10mg/kg/dose twice daily Periodic EEG, CBC, LFT must be done Needs close follow up

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Focal epilepsy confirmed on EEG Put on tegretol or lamictal

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