seizures

[akcpillai]

My daughter, 7 years old, admitted to hospital on 16.09.2009 with fever since 6 days and one episode of vacant stare followed by lethargy one day before.
O/E. Child ws  afebrile, Vitals - Stable, HR 96/mt, RR 24/mt, BP 100/60 mm Hg. CNS- No sign of meningeal irritation, drowsy, no focal deficits, CVS - NAD, RS - Clear, P/A-Soft, non-tender, BS(+)
MRI study -Normal, CSF study - Normal, EEG - focal seizures
All known viral test was negative (Herpes simplex, Japanese encephalitis, H1N1, Dengue)
Child was started with IV Ceftriaxone and IV Acylovir. One day of admission, child developed seizures, started as vacant stare, twitching of (R) side of face followed by tonic clonic movements of (L) hand and then right hand lasted for 2-3 minutes. IV Phenytoin and Phenobarbitone. On D2 of admission - Child had total 5 episodes similar type with focal onset with secondary generalization. Started on Tab.Carbamazapene and Leviteracetam. On D3 patient had similar seizures hourly with apnoeic episodes and had to be ventilated on minimal setting. No seizures on ventilator with midazolam infusion. The child is unresponsive to other conventional anti-epileptics.
Now it is 43 days in ventilator and when ever we tried to taper midazolam, seizure starts again (three trials). Child is repeatedly showing temp. of <102 F. No sign of bacterial or fungal infection.