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Hello, I Have Brother Aged 10 And He Has A

Posted on Sun, 14 Jun 2020

Question: Hello, I have brother aged 10 and he has a problem with his eyes. He keeps moving his eyes involuntarily. The doctors in my country have told us that it was pandas syndrome and they are applying a treatment. Apparently it is unsuccessful. The problem is that doctors in my country are not very reliable and due to the current situation of the world we are unable to travel. I would appreciate it if you tell us what tests he should go through or what should be done. I will leave my email address for contact- YYYY@YYYY .

Thanks in advance

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Hello, I have brother aged 10 and he has a problem with his eyes. He keeps moving his eyes involuntarily. The doctors in my country have told us that it was pandas syndrome and they are applying a treatment. Apparently it is unsuccessful. The problem is that doctors in my country are not very reliable and due to the current situation of the world we are unable to travel. I would appreciate it if you tell us what tests he should go through or what should be done. I will leave my email address for contact- YYYY@YYYY .

Thanks in advance

Answered by Dr. Pradeep Kumar Jain (1 hour later)

Brief Answer:
Please visit a pediatric neurologist

Detailed Answer:
Hi

I have gone through the details and do understand your concern.
Involuntary movement of eyes can be due to a number of conditions.
In Pandas syndrome there can be eye movement disorder but that is mainly during sleep time and there is associated abnormal behaviour with abnormal movement of other body parts.
Eye movement is controlled by muscles of eyes, nerves and brain. There can be abnormality anywhere right from eye to brain.
It would be difficult to find out the exact cause of abnormal eye movement without direct clinical examination.
I request you to attach the investigations and prescription copy so that I would better able to help you out.
Regards

Above answer was peer-reviewed by : Dr. Prasad

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Pradeep Kumar Jain (21 hours later)

Is there any way that I send videos.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Is there any way that I send videos.

Follow up: Dr. Pradeep Kumar Jain (4 hours later)

I have attached all the scans plus a blood test for rheumatism. If you have any problem with the image quality let me know. Also a note- when he started the treatment the eye movement became less common and then it started to increase again. Moreover I would like to send his video but I am unable to do it on this website. If you could send your email or any other way to send the video would be perfect.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Answered by Dr. Pradeep Kumar Jain (8 hours later)

Brief Answer:
Please reattach the images

Detailed Answer:
Hi

I am really very sorry for the inconvenience. I did not find the images in the report section.I request you to contact customer care to know about the video facility and also to know why your attachment has failed.
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pradeep Kumar Jain (7 hours later)

email sent please suggest

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

email sent please suggest

Follow up: Dr. Pradeep Kumar Jain (1 hour later)

I have sent the files through email (the one customer services showed). Please inform me if you don't get it.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

I have sent the files through email (the one customer services showed). Please inform me if you don't get it.

Answered by Dr. Pradeep Kumar Jain (55 minutes later)

Brief Answer:
Have seen the video, proper evaluation by neurologist is needed

Detailed Answer:
Hi

Thanks for sending the video clip

I have seen the video and there is sudden, jerky abnormal movement of head and eyes. Also there is slow rhythmic movement abnormality of fingers.
All these kind of movement goes in favour of choreoathetoid type of movement with opsoclonus type of movement disorder of eyes.
I agree with your doctor as this type of movement can be seen in PANDAS syndrome.
I would like to know some details like
For how long this problem is there..
Is there any associated IQ abnormality..
Any difficulty in walking or any history of fits..
Any recent history of hospital admission for brain fever or jaundice..
Please provide me details like if any blood test or any MRI brain/CT brain has been done.
What treatment he is receiving?
As with abnormality in eye movement there is associated jerky movement of head and abnormal movement of fingers are there, this appears to be a problem of brain, neurological system(not only eye).
From my point of view, direct complete neurological assessment with brain imaging like MRI brain, liver function test, metabolic profile will be needed.
Please get back to me with details so that I better able to help you out.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Answered by Dr. Pradeep Kumar Jain (0 minute later)

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Pradeep Kumar Jain (1 hour later)

I have sent the mail with the scans again.
It has started from 4th May. For your questions there were no abnormalities in anything and he has not gone for hospital recently for any other reasons. Metabolic test profiling and liver function test will be done tomorrow and I will send it to you. In your brief answer you said proper evaluation by a neurologist is needed. Should I talk to someone on this website, because we are unable to travel outside the country at the moment.

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Follow up: Dr. Pradeep Kumar Jain (15 minutes later)

Also when he was 2 years old a metal bar hit his head but nothing serius happened (to the bone).

Follow up: Dr. Pradeep Kumar Jain (0 minute later)

Also when he was 2 years old a metal bar hit his head but nothing serius happened (to the bone).

Answered by Dr. Pradeep Kumar Jain (13 hours later)

Brief Answer:
Please consult a neurologist

Detailed Answer:
Hi

Thanks for follow up

I have seen the mri scans, eeg and blood reports.
I m sorry to say but images are not clear and blood reports are also in some other language.
I request you to consult a neurologist with all these reports and also with details of current treatment. Neurologists are also available on this Ask A Doctor platform. You can take second opinion from him.
Wishing for good health of your brother.
Regards

Above answer was peer-reviewed by : Dr. Kampana