A three year old girl child, Rosy, was brought to Dr. A M Reddy clinic by her parents. First thing which Dr. Reddy noticed that the child was dull, drowsy and restless and he enquired, the parents if the child was having fever or is she on any medications, for which the parents replied in affirmative way that she was on anti-epileptic medicines from past one year.
The parents were taken for detailed case taking. Details of the case are given below:
Rosy was a single child to her parents, born out of non-consanguineous marriage. Mother’s age at time of birth was twenty five years and father’s was twenty eight years.
Before conceiving Rosy, mother had a history of one spontaneous abortion and was later diagnosed having hypothyroidism for which she was kept on Thyroxine 50 mg. Within three months of abortion she conceived again.
In the third month of pregnancy mother had some spotting because of which she was advised bed rest and medicines. Rest of the pregnancy was apparently uneventful.
The child was born by C-Section, birth weight was normal but birth cry was slightly delayed. After Rosy was born, she was developing normally, no major health complaints in first one year except for few colic episodes and occasional cold and cough. Her milestones were also in expected time period.
After the first year, she had an episode of high fever which led to febrile convulsions (fits), which was treated symptomatically by their pediatrician. After few days she developed again convulsions this time without fever. On a single day she had about four to five convulsions and was rushed to hospital. From then on she had been getting convulsions on and off and was started on anti-epileptic medicines.
The fits use to occur mostly in night time, occasionally even during sleep. From then on her development became delayed and her speech regressed.
Her eye contact was poor; she did not have any interest in interacting with children of her own age group and use to prefer playing alone. She became crankier and wanted always her mother to carry her. If she wanted anything it had to be fulfilled immediately otherwise she would start crying loudly, throwing herself backward, and becoming stiff.
She did not have functional play with toys and was mostly destructive. She was non approachable and if any relative like grandparents/uncles /aunts or any stranger use to come near her she starts howling.
She had fear of darkness and to sudden sounds but had no fear of animals. Music use to make her alive and she enjoys it very much. She was not very particular of dressing or colors. Following directions or instructions was poor and she could not identify colors, alphabets and shapes.
Physically she was under weight, skin was dry and hair was slightly brittle. She liked to eat indigestible items like mud, chalk, paper, etc. She was not toilet trained and her bowels also were not regular.
Based on her complete history a single dose of xxxxxxxx was given and parents were advised to taper her anti-epileptic medications. In two months of treatment her fits medicines were reduced by fifty percent, but after 2 months she had one episode of seizures.
After reviewing her case, a dose of xxxxxxxx was given and was advised for regular follow up. In next couple of months her fits medicines were completely tapered off.
In a year’s time her activity level increased, her crankiness reduced, was being approachable and she started repeating few words. In spite of stopping her anti-epileptic medicines, she did not report any episode of seizures. Parents were advised to join the child in a play group and she is doing well.