Subject: Re: EEG slowing
Forum: The Neurology and Neurosurgery Forum

Topic Area: Neurology

Hi. My son was diagnosed with D.K.A and new onset IDDM in November 98. At that time an EEG was done which showed 'slowing', which the neurologist said was nothing to worry about. Recently, I was told that his brain had stopped growing. At 22 months, his head is 45cm, below the 2 percentile. At the time of his dx of diabetes, he was 14 months. He had previously been diagnosed with faliure to thrive, developmental delay, hypotonia, +1DTR's, asymmetry in the use of upper extremities, subtle dysmorphism, 2 hair whirls, skull is fused and sacial dimple. He does not walk or talk. He had an MRI done while in the hospital at 14 months, that showed "slight prominence of the cerebral sulci and the prepontine cistern". The same neurologist who said the slowing on the EEG was normal, said his MRI was normal. I don't know what any of that means. No one seems concerned with the head growth failure. Crainistinsos (SP) was ruled out. He did have uncontrolled hyperglycemia for months before his dx of IDDM. He was IUGR, eitology unknown, and 4lbs, 4oz a 38 weeks gest. I need to find a neurologist who will look at him and let me know if there is anything I can do to make his brain start to grow again. Is their a growth horomone or something he can take? I have been told that uncontrolled hyperglycemia can lead to significant loss of nueral capacity resulting in retardation to relatively minor attentional problems. What I need to know is does he need to see a neurologist. No one seems concerned about his poor head growth, his delays and his EEG slowing. I am concerned! I don't know what it all means and I need some answers. His hearing is normal as well as vision. He recently began having reflux, an upper GI was done which showed slowed stomach emptying. Could that be autonomic neuropathy? I know this is long and complicated, but any help you could provide would be appreciated. They tell me he has a mental handicap, but they say that they can't tell me the extend of it until he is 3. Why is that the magic age? What if I wait until he is 3 and I am told that if I would have had him checked at 2 they could have done something. Please, any help????? Thank you

Dear Kim:

Sorry that your son has so many problems. It is difficult for me to make a comment on what the other neurologist had to say to you concerning your son's condition. Certainly from my standpoint, you son has developmental delay, both motor and cognition. It is unlikely that the DKA that signalled you son had diabetes caused the brain damage, from what it sounds like it was previously suspect to begin with. When a child goes into DKA, during the correction back to normal glucose levels, the brain often will mildly swell. This, combined with the metabolic shock of high glucose and ketone bodies, and low pH will give the EEG reading of slowing. This just means that the brain has been shocked metabolically. From what you are telling me, the MRI was not normal and likely this abnormality has been with your son from before birth (he was IUGR).

I would suggest that you seek out a good pediatric neurologist. Your son needs early intervention to maximize his potential. Your pediatric neurologist can coordinate all this. At least in Ohio, by law you and your son are entitled to this type of care.

Whether you son's brain has stopped growing. What was the head circumference at birth, 6 months of age, 1 year of age etc. It probably is that your son head (brain) has started off small and continued to be small but is growing. The measurement at birth is average of 34 cm, so your son's head size has grown since birth. The "rate" of growth is important and it sounds like your son's rate is somewhat slow. There is little one can do about brain growth except to have proper nutrition. We do not know too much about the regulation of neuronal and non-neuronal cells in the brain.

Again, seek out a pediatric neurologist sooner than later. The earlier the intervention the better.

Sincerely,

CCF Neuro[P] MD

Follow Ups:

• EEG slowing Kim 6/12/1999 (3)
  • Re: EEG slowing CCF Neuro[P] MD, RPS 6/13/1999 (0)
  • Re: EEG slowing .. 6/13/1999 (1)
    • EEG slowing CCF Neuro[P] MD, RPS 6/13/1999 (0)

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