Question of the Week

Question :

Posted On : 29 Jun 2007

How can I further investigate a neonate for its seizures and lethargy after the following investigations have come out to be normal:- Less Than br More Than
1} No H,o birth asphyxia, trauma. Less Than br More Than
2}serum calcium, blood Dextrose normal. Less Than br More Than
3} Work up for sepsis negative including blood culture and lumbar puncture. Less Than br More Than
4} CECT skull shows normal study. Less Than br More Than
5} ABG study normal {no metabolic acidosis, serum electrolytes normal- leave me in a doubt whether to investigate further on lines of a metabolic disorder} Less Than br More Than
6} no stigmata of intra uterine infection { TORCH TITRE-not done due to economical restaints} Less Than br More Than
Please guide me how to pursue this case. For an update the baby's seizures which started on day 3 of life are now under control on phenobarbitone, valproate and pyridoxine. But the cause for seizures still eludes me.

Expert Answer :

No expert answer available.

Answer Discussion :

safy nawar

further investigation to done,continous videoEEG,csf should done with estimation of glycine level in the csf,roule out other electrolytee.g Mg andNA level ,TORCH should done,MRI BRAIN,any way sure the pyrodexine you give is the last trial and baby responding so it may be pyrodexin dependency,EEG is very important to exclude its condition mimic epilepssy or epileptic synderomes

17 years ago

dr nitesh choudhary

other causes like hyperphosphetema, hypomagnesemia, hypo or hypernatremia, or benign idiopathic neonatal seizures

17 years ago

pediatriconcall

What is the EEG and Ultrasound of the skull? Also do a serum ammonia. Depending on the results of the same an MRI may be considered. Day 3 seizures, one needs to rule out metabolic seizures and pyridoxine seizures.

17 years ago

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