Hey, I need help understanding this letter from paed, pls help, long post, gonna type out whol letter so pls bear with me, ok, here goes......
I thought I would write this letter to you today to summarise the information which I gave to you today and also results of investigatins we have done on Jack so far.
Jack is now 13 mnths of age and he has suffered from epilepsy since age of 6-8 mnths(actually few weeks old we noticed it!!). At the same time he also showed evidence of delayed development, mainly in his head control, his attention(nonsense, he is always attentive!!!) and development of communication and speech, (again he is only 13 and a half months ....).
Over the past 6 mnths he has had difficulty in controlling seizures, occuring about 2-3 times a day, but can go a few days with none. His seizures have changed over the past 6 mnths from what we call infantile spasms where whole body stiffens for few secs to more prolonged seizures associated with staring, unresponsiveness, fisted hands &tense body lasting 10-20 mins and sometimes as long as 30 mins(40 actually).
Initially we treated him with nitrazepam but with little effect. We added epilim &he reached a dose of 4ml twice a day & I commenced him on lamotrigine today.
From the examination point of view he has bn growing in weight reasonably well & he is about 10kgs. His head circumference seems t have dropped in it's growth and at the beginning when I saw him at age 5 mnths his head circumference was 42.0cms which is between the 10th and 50th percentile. This has now dropped to the 3rd centile and his most recent head circumference was 44.8cms. Although it is growing it is growing slower than one would expect, and the end resultant is that of a smaller head than one woul expect for his age (my worry is will ths b noticeable as he gets older?!).
We did a 24 hr EEG recording which did show abnormalities coming from both temporal lobes.
He recently had an MRI scan of the brain & i gave results of this to you today
This has shown abnormalities in bth temporal lobes which is consistent with EEG findings. The rest of the brain did not show any specific abnormalities.
I explained to you that thse findings and also the fact that he is nw showing poor growth & development of his brain making his head smaller than usual & the difficulty t control epilepsy as well as the delay in development suggests that the brain lesion is responsible for all the probs. It's very difficult t tell from the lesion why it's happened but commonly it's unexplainable due t an incident happening in v early weeks of pregnancy or could b due t genetic miss programming.
We talked about the outlook for his development in the future and I felt that with combination of all probs which i have mentioned above it is v likely that he will continue t b behind children of his age with the skills he will need t acquire. It's v difficult t tell exactly how delayed he will be but time will tell & a longer period of observation will b helpful.
Can anyone help me out here, in easier terms and reassurance....& again I apologise for massssssssive post xxxxxx