Myoclonic epilepsy

Dear Dr.
              My 1 year old son is suffering from ailment diagonesed Myoclonic epilepsy, when he was 2 month old we observed seizure inwhich he was putting his head front(slam seizure) for 10 to 12 times at a strech twice or thrice in a day.His MRI brain reavels sgnificant reduction in volume of white matter pre dominantly involving bilateral frontal temporal and parietal lobes.Medication given  is sodium valporate, nitrazapam, lamtac,. He was given ijection Bicobal 2ml for 30 days daily, now he is given cynocobal syrup. My this medication his seizure reduced to 10 to 5 twice a day.Rest fooding is normal.Plz advice me about medication,wheather medication is going in right direction.We are also giving Physiotherapy throughout the day.he is not sitting and cannt able to hold anything nor he is able to talk.advice me sir,i m very worry about my soon.  

[Abhijeet Deshmukh, MD]

Hello.

Your son has what is called as West syndrome. Valproate is a good drug, but it will be needed in high doses, and there is a risk of liver damage (Hepatotoxicity) with it.

Vigabatrin is a first line drug for West syndrome. Only when Vigabatrin does not work, do we generally give Sodium Valproate. But please do not get confused with this. Continue Valproate and see the response.

The other two medicines (Nitrazepam and Lamotrigine) are suitable.

Expect some amount of developmental delay. Your son may not start talking and walking on time. Do not compare him to other children. He has the disadvantage of the epilepsy. Other's don't.

You will need a lot of patience and determination for your son's treatment. You are a caring father. I am proud of you.

Regards

[rajcharu]

Sir, thanks for quick response from ur side.In next maili will send u all the clinical report to u,for ur further advice.