Patient's question:
It was diagnosed as infantile spasms. Previously, when the child was 29 days old, a brain CT was performed, showing some hypoxia. The doctor said it wasn't serious, so no further treatment was sought. Later, when the child became ill, the diagnosis came too late.We have tried diazepam, carbamazepine, topiramate, phenobarbital, lamotrigine, prednisone, and have received ACTH and dexamethasone injections, as well as intravenous immunoglobulin. In the end, a craniotomy was performed (at Xinqiao Hospital in Chongqing). However, the condition has not been controlled, and the child is now taking Keppra. The child is now three years old and weighs 20 kilograms, and has been taking 800 mg without improvement. What should be the next treatment plan?
Doctor's answer:
To prevent the recurrence of infantile spasms and their transformation into tonic-clonic seizures or psychomotor seizures, the medication dosage should not be reduced even after the seizures have completely stopped. Instead, the child should continue taking medication for 2 to 4 years, after which the dosage should be gradually and cautiously reduced under the guidance of a doctor until it is completely stopped.Additionally, parents should pay special attention to the fact that when the child starts taking medication, follow-up visits to the hospital should be scheduled every 2 to 3 weeks. Afterward, follow-up checks should be conducted every 3 to 6 months. At the same time, it is essential to closely monitor for any toxic effects of the medication. Regular medical examinations should be performed to check liver and kidney function as well as blood counts. If any abnormalities are detected, further measures should be taken promptly.