Four days back, a boy of 9 years was brought to me by his mother informing that he had repeatedly winked his left eye and during this episode he was totally unresponsive. It hardly lasted for few seconds only. She thought it could be due to lack of sleep.
Second day they were travelling to their home by a bus, the child had one more such attack but with loss of consciousness for about 2-3 minutes. It was accompanied by jerky movements of left upper limb as well. He recovered completely on his own soon. The boy doesn’t remember these two episodes.
He is the only son to their parents & was delivered by C-section. His overall development was uneventful. His performances in school is excellent.
On interrogation it was found that the boy spends more time in watching cartoons and on smartphone. Even in sleep he mutters the dialogues of cartoons characters.
A clinical diagnosis of “Complex Partial Seizure” was made and he was put on Carbamazapine 150 mg bid (34.2 Kg x 50 mg). He is seizure free since then.
Parents were advised to council the child to sleep for a minimum of 8-10 hours and to restrict his involvement on TV & Smartphone to avoid provocation of cerebral cortical neurones which are put to lot of activities in such provocative situations discharging abnormal electrical impulses resulting in seizure/epilepsy.
Parents were advised to bring the boy for regular follow up for titrations of the dose and to know the prognosis. They were also advised to consult a specialist if they desire.
Now the case is open for discussion. I will respond to your views at the end.