Your opinion, doctors? Patient is 11 years old, not able to communicate properly, utters incoherent words, mental age lags chronological age. has H/O seizure attack 9 years back

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MRI film not available Report mentioned hypoxic ischemic encephalopathy due to perinatal injury to the brain. Suggest speech therapy , occupational therapy .Refer to Neurologist regarding Eeg & antiepileptic med.

If no seizure episodes in last 9 yr and he is not on any medication then no need of any antiepileptic at present and eeg will be inconclusive....no active focus will present at this time because 9 yr seizure free
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mental age lacks chronological age shows intellectual subnormality associated withabnormal behavior should go for developmental assessment n IQ test then treatment with training by special teacher

Thank you doctor
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Here is importance of detail history.There is global development delay with seizure disorder.so need education byEducator ,speech therapist, And occupational therapist .

Broccas area plays main role
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It is periventricular leukomalacia, a congenital condition affecting new born babies where there will be delay in motor and speech as well epilepsy. There will be sparsity in white matter along the periventricular area.

Hypoxic status resulted in underdeveloped brain ie retarted growth.

Thanx dr Dinesh Sharma
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NEUROLOGICAL DISORDER MODE OF DELIVERY HAS CHILD BEEN FULL TERM OR PRETERM IS MOTHER AND FATHER MARRIED FIRST OR 2ND COUSINS WHAT ABOUT THE STATUS OF OTHER CHILDREN

Intellectual disability due to hypoxia, need IQ assessment and VSMS adaptive score for severity of disability accordingly skill training.

Perinatal insult may be possible cause... Every pediatric patient must required perinatal history !!!

11 years old presenting with only communication difficulty and mental age lag with no physical difficulty ? 11 yr old should be involved in sports, be independent for ADLs and also have advanced fine motor skills not related to learning. Detailed neurological investigation, consider possibility of Autism spectrum disorder, seizures are seen in the spectrum and the lack of developed social skills may present as cognitive lag.. Refer to occupational therapy, remedial education and then after child has settled in this for 3-4 months you can advice for detailed learning evaluation.. Schooling is necessary , and integrated schools should be recommended bat the earliest for the child.. Counsel parents regarding need for school and therapy

Assess his developmental milestone in detail. Hypoxic ischemic injury is there so cause of presentation is obvious. Do one EEG and start appropriate antiepileptic medicine if not started yet. Educate parents about his condition and tell them please don't go through any quack and faith healer.

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