Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
My 4.5-year-old daughter had one severe grand mal seizure last month, after an EEG showing abnormal and put on Keppra. She was diagnosed with bects in frontal lobe not central. Now her MRI showed multiple tiny predominantly anterior cerebral subcortical white matter, areas of increased T2 Flair signal, nonspecific in etiology. Should I be worried?
Hello,
Welcome to icliniq.com.
I would like to know some further information about your daughter.
Was it the first episode of seizure to your daughter? Or she had prior seizures too? Did she have a fever before seizure with headache or vomiting? How are her developmental milestones? Is she growing like normal child of her age or little delayed? Has she some other significant medical history too? Was the seizure happened while she was awake or sleeping? On what basis she was diagnosed to have bects? Was MRI done with contrast or without contrast? I suggest you send MRI images. Also, please send the EEG report too as an attachment. On what dosage she is on Keppra, and how many times in a day? How much is the bodyweight of your daughter?
Regarding follow up
Patient's Query
Thank you doctor,
Yes, this was the first episode. Before this, she would have (what I thought) night terrors. No, she is very healthy. No fever and vomiting. She is right on the chart for everything but had digestive issues and severe constipation. She is an identical twin, the bigger of the two. It is well controlled now, and she took a probiotic a few times a week. She is allergic to Penicillin and gets contact allergies from certain foods. The seizure happened around 7 am after coming out of her sleep in the morning. I do not have an EEG report right now or a visual MRI. It was done while she was sedated and without contrast. She is on Keppra 3 ml twice a day oral. It is a 100 ml dosage.
Hello,
Welcome back to icliniq.com.
As you gave information and also the mentioned the report of MRI as "There are multiple tiny predominantly anterior cerebral subcortical white matter areas of increased T2 flair signal, nonspecific in etiology". Since they mentioned it as nonspecific, it is very difficult to say exactly what it is.
If your neurologist says epilepsy be bect firmly, there may be a good prognosis. In many patient's bects can have spontaneous remission by adulthood. But I assume that it may be a probable diagnosis, and with further time course, we will know the pattern of seizures (if further seizure happens).
You can discuss it with your neurologist after showing the MRI images if a contrast study can help know further about these MRI lesions or wait and watch for it.
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Neurology
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