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Seizure Activity


Question

Our son is six and had his first seizure during school. His eyes rolled back in his head, he did not fall, and it lasted only a few seconds. Afterwards, he slept briefly and then was okay, went about playing, and seemed happy. Between the first seizure and the time I got to school, he had four more such seizures, slept briefly and then was fine. He was taken to the ER and nothing significant was found. The neurologist didn't think an EEG would be of much use and said that an MRI could be done. He wants to put our son on Keppra, Zongran or Neurontin. I’m concerned, because there is no research done with children under 16 with the first two meds. And I am concerned about the possible behavioral side effects or mood swings that are noted with the medications. Our son is really making nice progress right now and we are concerned that these medications might adversely affect his development. He has not had any additional seizures since first ones. Can you please respond to these concerns and the course that the treatment and evaluation should take? Is it unusual for seizures to develop at this age? Do most children with CdLS manifest them earlier in life?

Answer of our experts

If I understand correctly the seizures that were described were brief and all close together, and there have been no other seizures since. I would get an EEG to see whether there is epileptiform activity at baseline and if yes, to see what type of brain wave discharges, as this helps in finding the right medication for him. However, if the EEG is not clearly abnormal, I think one could justifiably also hold off medication for now and see whether he would have a seizure again (viewing the little cluster of seizures together as his first episode). If he goes on to have another seizure, one would be more certain that he needs medication and then pick the right one that fits his type of seizure and EEG. There is no typical age at which children with CdLS develop seizures (if they do); it is a risk throughout their lives

CB/ TK 7-13-10

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Recommendation(s)

Autonomic nervous system

R47
Seizures in individuals with CdLS should be treated using the general management schemes.
R48
An MRI of the brain should be considered only if the individual with CdLS shows neurological signs other than microcephaly (smaller than normal head).

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