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| SPECIALIST ANSWERS
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Question |
3month male of nonconsanguinity presented with tonic convulsions with no neck control till time.Routine investigations for convulsions are normal.CT brain showed frontotemporal atrophy,how is that significant at this age . S.ammonia is also 3 times the normal value.Convulsions controlled with 3 drugs.
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Answer |
An MRI would be warranted as CT may not be very specific. It is imperative to know whether there are any white or grey matter changes? Also what is the birth history and birth weight? Family history is also necessary. Is the ammonia high prior to the start of the anticonvulsants or after adding the ACT. Ammonia may increase following valproate. If ammonia is persistently high, one must rule out metabolic disoders and do serum electrolytes, blood gas, blood sugar and urine organic acids. Also EEG is a must.
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