Need Help!!!!

[bambi1976]

I have a 23 yr old son born with Oro Facial Digital Syndrome. Just in the past 2 months he has been presenting seizure like activity in the morning while eating.  Symptoms include jaw tightening, drooling on one side, unable to swallow at times, jaw quivering,and what appears to me, the vagus nerve swallowing on its own. These spells last from 30 mins to a couple hrs.  He is responsive though very sluggish.  During the worst episodes, his eyes are rolled up in his head and are bloodshot.  He always seems to vomit after the bad spells.  Blood work, CT scan and EEG were all negative.  A trip to the ER during one episode produced no answers.  (CT scan was performed then with bloodwork).  He is active, works part time and is able to communicate this "aura" from the onset.  I am very confused as to why I see this only during breakfast.  He takes Ritalin LA 40 mg once or twice a day and Risperdone 2mg at bedtime.  He has been on the Ritalin since he was 4 and the risperdone since 16 yrs old, so the meds arent new.  HELP!!!!!!

[Shazia Alam, DO]

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.

Reading your son’s symptoms, make me think that he may be suffering from reflexive epilepsy, in which seizures occur in response to very specific stimuli or situations, as if the seizure is an automatic “reflex.”  Either way, your son definitely sounds like he may have a focal epilepsy, which means it is arising from a specific area of the brain.  

I would recommend your son seeing a neurologist and being evaluated because he may need to be started on medication to prevent these seizures.  Sometimes, we also hospitalize these patients in Epilepsy monitoring units so that we can “watch” their seizure and further characterize their epilepsy or at least rule them out.  

Hope this information was helpful.  

[bambi1976]

Thank you for getting back to me.  He has had a neurologist since birth and we will follow up with him again when we get home.  We are away for the summer.  He ordered the EEG and bloodwork back in May and they were normal and the CT was done during an ER vist during one of these episodes and that was normal.  My only question is why does it only happen at breakfast and not at other times of the day when he eats??