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Why is my friend’s daughter suffering from persistent convulsions?
Question
My friend's 14 years old daughter had a convulsion while sleeping 11 years back. She was on Epival syrup for three years after a brain scan and the medicine was stopped by the doctor as she never had convulsion during the course of medication. Six years after stopping Epival, she again had a convulsion during sleep and within a span of a month, she had four convulsions. We consulted a neurologist, who after reviewing EEG, MMR of brain and some blood tests, prescribed Vinlep (150 mg) twice a day half an hour before meal. Doctor told us that it was a symptom of epilepsy. Now she is taking Vinlep 150 mg twice daily for the last 7 months. It may be noted that she was never suffering from fever whenever she had convulsions. Why is she suffering from persistent convulsions and why is she performing poorly at school?
Expert Answer
R
Dr RK SabharwalJan 27, 2011
Senior Consultant, Child Neurology & Epilepsy,
Sir Ganga Ram Hospital,
New Delhi
Sir Ganga Ram Hospital,
New Delhi
Your friend's daughter does have Epilepsy. Your neurologist must have classified the Epilepsy, and told you whether it is Idiopathic, Probably Symptomatic, or Symptomatic. This the neurologist does after taking a detailed history, performing a neurological examination and doing an awake and sleep EEG, and often an MRI.
Vinlep is the right medication to be used (versus sodium valproate - Epival) in a 14 year old girl, and having seizures in sleep. Your neurologist may like to set the dose in the range of 15-20 mg/kg/day. The prognosis of Epilepsy, as in most diseases, depends on the cause of epilepsy. Children who:
As regards the child's poor scholastic performance, I would strongly advise that you contact a clinical child psychologist and get the child assessed for the following:
Vinlep is the right medication to be used (versus sodium valproate - Epival) in a 14 year old girl, and having seizures in sleep. Your neurologist may like to set the dose in the range of 15-20 mg/kg/day. The prognosis of Epilepsy, as in most diseases, depends on the cause of epilepsy. Children who:
- are neurologically normal,
- have had only few fits before starting treatment,
- have a normal MRI brain,
- preferably a normal EEG at the end of treatment,
- are well controlled by a single medication,
- and have remained seizure free for 2-3 years, have the best chances of remission.
As regards the child's poor scholastic performance, I would strongly advise that you contact a clinical child psychologist and get the child assessed for the following:
- Developmental quotient (DQ)
- Attention deficit disorder
- A learning disorder / dyslexia
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