An 11 year old male child with history of intellectual disability(severe),hyperactivity,decreased self care,sleep disturbance on and off from last 5-6 years.Patient's blood investigations like LFT,CBC,RBS,KFT are within normal range.EEG and imaging not done yet due to financial constraints.Patient is on syrup Valparin(200mg/5ml) 5ml bd and Risperidone 0.5mg 1hs...he remains manageable for few months in between and again became restless for last 1 and 1/2 months.Now again without any new medicines patient is back to manageable state.could it be some seizure that the episodic behaviour disturbance arises?How do i manage this case?please help.


As patient is mentally retarded we don't expect much improvement in such patient. Psychological and psychosocial management might be helpful to like personal training etc For seizure rule out the cause. Is it was due to any physical illness or something else and also rule out Dissociation as MR patients mostly neglected in family . For medicatio yes he shown improvement on valproate and risperidone you can continue with this if any psychosis found in MSE you can further hike the dose of risperidone

thankyou doctor

Mange seizure treatment under paediatrician with behaviour disturbance tablet aripriprazole and risperidone , can try clonidine tablet

Thank you doctor

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