Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
My 2.75-year-old son started (Thursday night) with these twitches and jerks. He is battling a cold it appears with a runny nose, watery eyes, and sneezing. No fever. This has been the same time as these motor items have developed. Overall he has acted fine and there is no change in consciousness.
He was seen one month ago about starring spells but neurologists thought it was low risk for seizures. We are not sure what these are? He does them when at rest versus active playing or eating. We want to try to get him in to the test but given the current situation, we are hesitating to take him. We need to do a sleep study.
Is this seizure activity? Could it be related to cold? Could it be growth related?
He was just to PCP and development is well above age group for mental and physical. He does twitch and jerk as he falls asleep often. Also, he is prone to crying and talking in sleep. He is not screaming but enough to get your attention. He is asleep when we check on him. Please help. I have attached the videos.
Hello,
Welcome to icliniq.com.
I passed carefully through your questions and reviewed your videos. (attachment removed to protect patient identity).
In the first video, I cannot distinguish, but the last video is very suggestive of seizures.
For this reason, I would recommend performing an EEG (electroencephalography). I understand the situation, but I do not think that this is an emergency as these episodes are not so frequent (they usually occur several times a day). You can wait a month or two as the situation of coronavirus is more clear.
You should discuss with his pediatrician about this. I do not think these episodes are related to a cold. As he has no fever, I would exclude any possible relationship to the cold.
I hope this helps.
Patient's Query
Thank you doctor,
He also has them on a very frequent basis while sleeping. Does that change the urgency? I put my hand on him and the twitches were quite a bit. So if you would extrapolate it would be substantial over the course of 24 hours. What type of seizure would you call this? I would be concern for something more than epilepsy, as a lesion or tumor?
Hi,
Welcome back to icliniq.com.
It seems to be generalized epilepsy and it is not related to any tumor. There are many benign types of epilepsy, which can cause a similar clinical situation. It can be absence or myoclonic seizures. They are both generalized types of seizures.
But an EEG is necessary to determine the type of seizures and then decide if further examinations (brain MRI, etc), are needed or not. That is why you should schedule an EEG with his doctor.
I hope this helps.
Patient's Query
Thank you doctor,
Could this be just a benign thing that would not require medication or would just go away on its own?
Hello,
Welcome back to icliniq.com.
Being benign does not mean that it would not need medication. But, it means that it will not harm his brain and it will be cured within some years.
Medication is needed to help reduce the seizures in number and severity because if seizures last for a long time, they can cause falling or difficulty in breathing and can harm the brain.
Anyway, an EEG is necessary to determine if these are seizures, and the type of seizures if present. The type of seizures will indicate the type of treatment and the need for further tests.
I hope this helps.
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