My husband and I are considering adopting a boy that was shaken when he was under 1 year of age by his birth father. In total he had 5 brain bleeds. He was treated in hospital for over a month and released. He received some physiotherapy because his right side was weaker than his left. Later that same year he had meningitis and was again admitted to the hospital and treated. He is now 4 years old and is meeting all of his developmental and physical milestones. His speech is good and he is described as intelligent by his foster family. We understand that he may experience some learning delays which doesn't trouble us. My questions are: What is the likelihood that he will develop issues as he gets older? What is the likelihood that he could develop debilitating seizures? What is the likelihood that he will have major behavioral issues? Any insight you can provide would be most helpful. Thank you
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
Seizures post head trauma may occur up to 5% of patients with closed head injuries. The risk of developing seizures post injury is related to the severity of the head injury. Severe head injury is defined as loss of consciousness or amnesia. The interval between head injury and seizure development varies. If the seizure arises weeks to months after injury, it is referred to as posttraumatic epilepsy. The frequency of these seizure types tend to decrease with time. The treatment is accomplished with a single antiepileptic medication, if clinically indicated. It is important to remember that every medicine has risks and benefits. If a cortical scar for the epileptic focus is present on MRI and the seizures are not controlled with medications, surgical resection may be an option.
Memory gaps (aka traumatic amnesia) usually remain in patients with cerebral injuries. The memory gap usually spans a period from before the accident to some time following the accident. The gap may be filled with what is told to them. The severity of the head injury and the longer the gap in formation of new memories, the more likely permanent damage will be. Studies have shown that maximum degree of improvement is seen within 6 months of the injury (in adult patients).
It is difficult to comment directly on the risks of cognitive and physical delays your child may have. Also, your child will have a higher risk of developing epilepsy compared to the general population given the head injuries and previous meningoencephalitis. It will be important for your child to continue with physical and occupational rehabilitation as needed. Also, it will be important that learning disabilities are recognized early, if they occur, and appropriate arrangements would then need to be made to ensure the best learning experience at school. Lastly, does your child have a pediatric neurologist and/or ever had a scan of the head? The former may be more important as time passes. The latter would be more of an interest to determine the extent of damage that may have occurred with the previous traumas.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Please don't let the possibility of seizures in the future affect your decison to adopt a child who desperately needs a loving family.
If he's learning well and on par developmentally than you are already ahead of the game.
Please take this from a mom to one beautiful severely mentally challenged little boy with seizures. the seizures are the least of our problems and they likely can be controlled with medication. ;)
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