Question

A 4-year-old and 3-month-old child is unable to walk independently, can only crawl, cannot speak, and cannot recognize people. On the 7th day of life, a severe neonatal jaundice was discovered with a bilirubin index of 490, fever of 37.5 degrees Celsius. The child was hospitalized for blue light treatment without blood transfusion. The jaundice subsided three days later. At 20 months old, the child underwent four sessions of pediatric rehabilitation therapy, but the effects were not significant, and the treatment was stopped. Magnetic resonance imaging revealed an imbalance in the ratio of white matter to gray matter in the brain. Epilepsy appeared at the age of 2.5 years, with each seizure lasting a few seconds and occurring 2 to 3 times every 2 to 3 months. The child received some treatment. In the past two months, the seizures have become particularly severe, and sodium valproate, an antiepileptic drug, has been started. However, seizures still occur; is it necessary to switch to other antiepileptic medications?

Answer

Based on the provided information, the child’s primary diagnoses are cerebral palsy, epilepsy, and intellectual disability. The child is currently unable to care for themselves and epilepsy is still occurring despite medication treatment. In fact, epilepsy is a complication or associated symptom of cerebral palsy rather than a direct cause. You have only been treating the child for two months and seizures are still occurring, indicating that the medication has not yet fully taken effect. It is necessary to continue taking the medication consistently to achieve effective plasma drug levels.