Age: 1.0
Sex: F
Vaccine: DTAP, HIBV, MMR, PNC13, VARCEL
Symptoms: Laboratory test normal, Muscle spasms, Nuclear magnetic resonance imaging normal, Rash, Speech disorder
Clinical narrative: My daughter received immunizations on 10/25/2012. At the time of immunizations, she was not ill nor did she have a fever. On Nov. 02, 2012, in the later afternoon, I noticed my daughter had a rash on her neck, chest and face that suddenly appeared. I called her Dr. and was told a Nurse would return my call. Once the Nurse returned my call, she informed me that this is a normal reaction to immunizations, but if I would like I can bring her in or take her to Urgent Care. The Dr. office was going to close, so I said if it does not go away, I would take her to Urgent Care. Within a couple hours, the rash disappeared, and I was not concerned since she had been feeling fine. Approx. 2 weeks after, I noticed my daughter going from crawling to sitting and making chewing motions with her mouth, which would cause me to look in her mouth, but never finding anything. She continued to do this at any time of the day and throughout the day several times. It very quickly advanced within days to chewing motion, staring off, not reacting to surroundings and making a motion with her left hand as if she was rubbing something between her fingers. I called her Dr.; she suggested I bring her in. She stated it sound like a Staring Spell and referred me to a Neurologist; there they did a 30 min EEG, at that time nothing had shown up on EEG results. From here on, it continued to get worse and increased in frequency and intensity. She now was having all of the above listed as well as eye twitching. I called her Dr. and she suggested I take patient to the ER. I took her to Hospital ER, where I notified them what has been happening and that she had 6 episodes that day, she had one while waiting in ER and I notified front desk, they had me wait an additional 3 hours before being seen. My daughter was seen and sent home with a referral to another Neurologist, which would take two or more weeks to get an appointment. The next day, she continued to have these episodes, I took her to another ER. She had an episode while waiting, I notified Front Desk and they admitted her immediately. They began blood work and additional tests. Blood work came back with normal results. They transferred us to downtown Hospital where she was admitted and remained for 3 days while tests were done. While there, they conducted two EEG's. The first one was a 30 min, with nothing found. They ordered another EEG, for 24 hours, which seizure activity had been recorded. MRI results were normal, additional blood work results were normal. They diagnosed her with Complex Partial Seizures and began KEPPRA before discharge home. While home, she continued on KEPPRA, but unfortunately the medication did not help and her seizures increased to full body shaking and spasms several times throughout the day, she would be walking or playing and with no warning drop to the ground and convulse. I made regular daily calls to the Neurologist at Hospital and made an appointment with Dr., Epilepsy Director. While there, my daughter had a seizure where the doctor said it was a Tonic/Clonic type. Her diagnosis was now Complex Partial with Secondary Generalization Seizures. Eventually we maxed out the allowed dosage of KEPPRA accordingly to her weight and age. On 12/25/2012, we were admitted again to the Hospital to try a new medication. She had to stay overnight for observation while they switched her medication. The following day she was discharged and sent home to begin TRILEPTAL. With the help of this medication, her seizures are now under control. With seizures under control, her Pediatrician, I, and Neurologist noticed over time that she was not talking. I called office to have her speech evaluated. At the age of 2, she had verbal communication of a 13 month old. She began Speech therapy right away and has recently been phased out due to her turning 3 years old in October. While her speech has improved, she has been referred to be evaluated by the School District. Before the seizures began, my daughter was babbling and saying simple words, making progress with her speech and was on target. Once the seizures began, she babbled less and any words she may have used before, she no longer said. She was quieter.