2 month baby - seizure and high lactate

[vvga]

i have a 2 month old daughter, she had her first episode of seizure on her 5th day (2 episodes of clonic seizures and 3 episodes of multifocal seizures). she is right now on gardinal 15mg and no more episodes of seizures occurred after that (touch wood).
Her brain MRI reports as "multifocal non enhancing punctate areas of FLAIR hyperintensities with some showing diffusion restriction in bilateral periventricular regions with diffusion restriction in splenium and genu of corpus callosum and MR spectroscopy showing increased lactate levels"
on recent tests it was found that her blood lactate and pyruvate levels (arterial samples taken) were high, 62 mg/dl and 6.5 mg/dl respectively.
the metabolic screening and CSF test report says "normal"
the doctor says her development till now is normal but high lactate levels are serious and bound to cause probs in the future

Im planning to show her to a paed neurologist in bangalore.

my questions are,

should i show her to a paediatrician or a paediatric neurologist?
What are the consequences of high lactate levels and most important of all will she be able to lead a normal life???

Thanks in advance

Regards
viv

[vvga]

Dr Kaul,

thanks for ur reply.
The lactate levels during last test (1 month back) was only slightly higher (30 mg/dl, sample taken from vein) but this time it was 62 mg/dl (arterial sample). was the test done properly? her CSF lactate level at birth (8th day) was 15.6 mg/dl. can the lactate levels shoot up so high in 1 month? and im taking her to a ped neurologist this week.

Regards

Viv  

[S. Kaul, MD]

Hey Viv!

While lactate and pyruvate itself could be responsible for the symptoms, their elevation is often indicative of an underlying cause such as metabolic issues, neuronal injury etc. and further evaluation to look for a primary cause and consequences would be required. She would require a detailed evaluation by both a paediatrician and a paediatric neurologist, preferably at a university/ teaching hospital.
Hope this is helpful.

Take care!