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    Neonatal benign seizures, twitching, jaundice, done phototherapy. Gardinal prescribed. Is her treatment right?

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Posted on Thu, 4 Oct 2012 in Epilepsy
Question: Hello Doctor,
My daughter, born on 23rd March12, is suffering from neonatal benign seizures. We first time observed the twitching of her left side when she was 5-6 days old, at that time she was suffering from neonatal jaundice, the bilirubin levels were at 28.0 ( I dont remember at this moment whether it is driect or indirect). We admitted her to a children’s hospital nearby for jaundice, there she again had those twitching or convulsions on the same night, but later on for next 1-2 days she was normal, bilirubin levels were quite down after phototherapy so doctor gave discharge. After bringing her back to home she again had convulsions on 28-29th March so we again went to same hospital, doctors tested many aspects like blood glucose level, electrolyte balances, calcium and other important metal ion levels in the body, even the brain infection, every thing came normal. So for the treatment part they prescribed Gardinal via IV route for next 2 days. Then after no convulsions so again after discharge we took her to home.
Again on 3rd Apr she suffered of the same for at least 2 minutes and 3-4 times in few hours of span so we again admitted her to the same hospital. There we did EEG of her and later we did her CT scan and MRI. EEG reports were showing some problem but CT and MRI scanning reports came normal so doctor prescribed the Gardinal via IV and later on slowly via Oral route.
Everything went normal for next one month untill Gardinal was being given to her. On 5th May doctor asked to stop the gardinal to see if she has recovered or not. On 8th May she suffered of those seizures again, so now doctor has increased the dose to 3ml. Now after that she is being close to normal but today we again observed the same seizures, this time the duration was a bit longer, 3minutes and with both the sizes of her body, saliva kept on droping in the form of bubbling from her mouth.

I need your help in this regard. Please tell me if the treatment she is undergoing is right or do we need to follow something extra or different.

doctor
Answered by Dr. Shiva Kumar R 1 hour later
Hello

Thank you for sending your question.

Your question is a good one and I will work on providing you with some information and recommendations regarding the problems you are experiencing.

From the descriptions given to me it looks like your child is suffering from complex partial seizures of probable right brain origin. She also had Hyperbilirubinemia also called as pathological Jaundice which can rarely cause convulsions. She has recurrence of seizures after the withdrawing the drug (Gardenal) indicating her epilepsy is not cured at this point of time.

My recommendation would be for you to continue on Gardenal in the prescribed dose for at least one year from now to control the seizures. If no seizures are seen during the next one year we can taper and stop the medicines slowly. As the current EEG is abnormal I advise you to repeat an EEG before attempting to stop the medicine.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate.

If you have any additional concerns regarding your question I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shiva Kumar R 47 hours later
Respected sir,

Thank you for the answer. I would definitely suggest my doctor the recommendations you have given. Please let me know whenever you will find something more about this disease.

Thank you,
XXXXXXX
doctor
Answered by Dr. Shiva Kumar R 2 hours later
Hello

Thanks for the comments.

Wishing your child good health.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Shiva Kumar R

Neurologist

Practicing since :2001

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