3 yo with partial complex seizures and defiant behavior

[Rosemari]

My son began having partial complex seizures originating in the frontal lobes when he was 9 months old.  There is not family history of seizures and no known cause for his. He has been on Tegretol, Depakene, Topamax, and is now on Trileptal and Lamictal.  He also takes Clonazepam at bedtime. His seizures have been poorly controlled since July '03.  He was having approximately three a week.  We are still increasing his Lamictal doseage, and his seizures are now less frequent.  He is exhibiting very defiant behavior at daycare, and to a lesser degree at home.  He hits, spits, kicks, etc.  He has periods when he is loving and well behaved and periods when he seems to be almost manic. Some nights he cannot go to sleep.  I have found him in his bedroom at 10:00PM with his toy vacuum, vacuuming his room. He normally goes to bed at 8PM and I wake him at 6:30AM. He will walk into the living room and "sweep" everything off the end table and onto the floor.  If he finds money, he will put it in his mouth and then come and show me.  He will use the potty if I take him, but he has never told me that he has to go.  He will use the potty on himself and then come and tell me most of the time.  He is also clumsy for his age.  He can walk up and down stairs, but he still trips when walking on flat ground.  He can't ride a tricycle. He turned three on April 24th.  I am concerned that there is something more going on with him than just being a strong willed child.

[Kevin Kennedy, Ph.D.]

Yes, I agree with you, more is going on than can be accounted for by a strong will. It would help clarify the situation if you could arrange for a broad evaluation by a developmental team: developmental pediatrician, developmental psychologist, child psychiatrist, speech/language clinician, occupational therapist. These various professionals can collaborate with the pediatric neurologist. The medication your son is taking to treat his seizure disorder could well have a stabilizing impact on his behavior, but it does not appear to be doing so. This in itself warrants additional evaluation.

[DinaGrimes]

My daughter has Petit Mal seizures (7 yrs old in 1st grade).  She was first put on Depakote and within days became a VERY angry, uncooperative child both in school and at home.  The doctor kept insisting that it was not the medication, that Depakote did not create these behavior changes.  As time went on the situation got worse and the Doctor finally agreed to take her off Depakote but told me that it would not make any difference.  Within two days of being off the medication our daughter was back to her normal self, much happier, much more cooperative.  She is now on Lamictal.  She seems to be doing very well though she does seem to have some problems falling asleep.  It is not bad enough to take her off Lamictal.  I hope our experience helps shed some light on your problem.