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Posted On : 08 Oct 2023

A 12-year-old boy was admitted with a high fever diagnosed as enteric fever. In the hospital, he had an episode od of uprolling of eyes with the increased tone of all four limbs he was treated with Diazepam and epsilon loading. This was his first frank convulsion. earlier he used to give a faint smile with slight uprolling of eyes but without loss of consciousness or increased tone or any abnormal movement, which used to last for a few seconds during these brief episodes when parents used to ask if he was not aware that he was smiling neither he used to respond during that brief period? Could they be absence seizures? His CT scan is normal. Now he is on valparin @ 20 mg/kg and Frisium still frank convulsion persisting. EEG facility is not available he will be referred for EEG and MRI when the convulsion stops how should he be managed what could be the cause?

Expert Answer :

Answer Discussion :

H

hamdi erfan

0

Enceohalitis must be considered
AB in meningetic dose

A

abdo farea

1

phenobarbitone

H

hizbullah khan

0

MRI and EEG studies are mandatory,adding IV methylprednisolone as add on to anticonvulsant might be helpful

A

Amani Baldo

0

consider encephalopathy; add dexamethaxone cerebral dose

M

mohamed mustafa

0

May ADEM.. need h8ghbdose steroid

Answer 1

He should be treated with phenytoin, Phenobarbital (if liver function ok), or add Keppra if available. The cause is most likely postinfectious encephalitis. If he is in status epileptics, he may need to be put in a pharmacologic coma. lumber puncture has been to be done.

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