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Jerk movements in arms and legs with twitching sensation. Taking medicine for epilepsy. Any advice?

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General & Family Physician
Practicing since : 2009
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My name is XXXXXXX, my 17 yr old son has been having Jerk movements in arms and legs, it became more severe lately that he even fell when he had the attacks. It looked like his whole body was twitching his arms knees and legs twitching then his body got down to the floor. But he didn't loose consciousness. He has been examined by a neurologist and epilepsy/seizure was ruled out. All EEG, MRI & CT scan of brain, blood works were normal. He was prescribed Baclofen 10mg twice a day, it seemed better at the beginning of this med, but he fell 4 times in 2 wks lately, I wonder if Baclofen is the right medication. He is also on a small dose of Zoloft 25mg from his family doc, he appeared to be mild depressed but he is doing better now. I'm worrying of his falls very much, hope to get advice.
Posted Mon, 4 Mar 2013 in Brain and Spine
Answered by Dr. Luchuo Engelbert Bain 2 hours later
Hi and thanks for using health care magic.
It was right to suspect an epileptic seizure with scenario, which you describe. It’s true that the EEGs, MRIs and CT scans of the brain were normal. However, epileptic seizures are not always accompanied by loss of consciousness. These seizure types with normal levels of consciousness are called simple epileptic seizures. At times, special EEGS may need to be done on the child for a longer period, maybe the whole day or when the child is asleep. Although the examinations done were negative, simple epileptic seizures still remain part of the differential diagnosis. At times, patients are put on trial treatments and managed as simple, and in this case partial towards generalized seizure. Discuss with the child to know if he has been taking any drug lately or not. Other diseases could equally cause jerky movements like complications of Acute rheumatic fever and some neurologic syndromes. It should be interesting knowing if this is the very first time your son is experiencing this, whether there is a family history of epilepsy or such movements or not. Electrolyte disturbances especially when acute could also present as such. A complete electrolyte panel especially for Calcium, Potassium, and Magnesium is worth carrying out.
Seeing another neurologist is a good option. However, still believe it's too early to completely rule out a possibility of an epileptic seizure, which could very probable, with the contribution from his past medical history.
While waiting, Baclofen and Zoloft as prescribed by the neurologist are useful and an ideal option. Do not hesitate taking the child to an emergency service if you notice aggravation of symptoms or onset of new symptoms.
Thanks as I hope this helps as you wait to see your neurologist,
Best regards and fast recovery for the child,
Luchuo, MD.
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