What's the reports says?. is it serious condition? PROGNOSIS? management?. . patient is premature baby. 2yrs old. functionally stable. doing all well. 2months back his sugar level downs and one episode of epilepsy occured for 2 to 3 mints. then till date no any such episode. . what to do now? any other suggestions? plz share.

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@Dr. Akshay Ingole Sir! PVL Periventricular leukomalacia (PVL) is a form of white-matter brain injury, characterized by the necrosis (more often coagulation) of white matter near the lateral ventricles. Those generally considered to be at greatest risk for PVL are premature, very low birth-weight infants. Affected individuals generally exhibit motor control problems or other developmental delays, and they often develop cerebral palsy or epilepsy later in life The extent of signs is strongly dependent on the extent of white matter damage: minor damage leads to only minor deficits or delays, while significant white matter damage can cause severe problems with motor coordination or organ function. Some of the most frequent signs include delayed motor development, vision deficits, apneas, low heart rates, and seizures. Seizures: Seizures are typically seen in more severe cases of PVL, affecting patients with greater amounts of lesions and those born at lower gestational ages and birth weights. Treatment: Currently, there are no treatments prescribed for PVL in Allopathy. All treatments administered are in response to secondary pathologies that develop as a consequence of the PVL. Because white matter injury in the periventricular region can result in a variety of deficits, neurologists must closely monitor infants diagnosed with PVL in order to determine the severity and extent of their conditions. Prognosis: The prognosis of patients with PVL is dependent on the severity and extent of white matter damage. Some children exhibit relatively minor deficits, while others have significant deficits and disabilities. So, regular follow up is must. Consider Constitutional Remedy like like Baryta carb/Calcarea carb/Cal phos according to totality.
Thank you for such detailed explanation! @Dr. Subhashkumar Bharti
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Periventricular leucomalacia aa MRI report shows is disease of primarily premature babies which is white matter damage caused by decreased blood supply to the area at the time of birth .Disease is generally not progressive. Seizure activity in this case was perhaps due to decreased blood sugar or some electrolyte disturbance at that time.Otherwise child should be considered for serial evaluations and should be looked for other neurological or mental deficits. I don't think he should be on regular antiepileptics.
Thank you sir
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Control blood sugar. Hypoglycemia episodes will cause further brain damage. Control blood pressure. Control siezures. Avoid cerebral oedema. Convulsions developmental delay motor devlopement.Cerebral palsy takes place. There is no medicine for this. Physiotherapy occupational therapy may help in CP. Progressive damage may go on though asphyxia cause is removed.
Thank you sir
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This disease is usually present in premature birth babies. THE WORD HYPOXIC MEANS LOSS OF OXYGEN SUPPLY AND INSULT MEANS LOSS OF CELL FUCTION DUE TO LOSS OF OXYGEN. LEUKOMALACIA SOFTNESS OF WHITE MATTER OF BRAIN.
Thank you sir. What's the PROGNOSIS? Is it consider as NORMAL at this stage? Or may further complications occurs as age
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Periventricular leukomalacia Sequele of perinatal hypoxic damage to brain Epileptic episode may not be related to hypoglycemia, could be symptomatic epilepsy, AED to be started on repeat episode
Occipital lobe involvement described with hypoglycaemia. May be there is increased risk of visual issues and epilepsy.
Yes sir. The sclera of both eyes seems to be pale yellow. What does it mean?
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Intrapartum asphyxia causes cerebral palsy. And motor function involvement occurs as the age advances.
Thank you sir
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Sir calc phos Nd vanadium use full
MRI images not in good presentation, difficult to read, MRI report says PVL. PVL is hypoxic ischemic insult in Preterm neonate at perinatal time. It represents static encephalopathy. One has to watch and periodically examine for signs of develmental delay and intervention at appropriate time with physiotherapy, visio audiological evaluation. Refer the case to a Centre for physical and mental handicap/ Developmental Neurologist.
@Dr. M V Subramanyam @Dr. Rajan N. Iyer @Dr. Subhashkumar Bharti @Dr. Aniruddha Lele @Dr. T Sankar wants your help here.
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