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Abstract: A 5-year-old child presented to the outpatient clinic with a family member who reported that the child had been dancing during sleep since childhood, which had been gradually worsening recently and was accompanied by a throat noise. He was diagnosed with benign epilepsy by EEG and cranial MRI. She was subsequently treated with levetiracetam tablets, and her seizures gradually decreased and she rarely has hand-waving during sleep.
[Basic information] Female, 5 years old
Type of disease】Benign epilepsy
Hospital】Shandong Provincial Third Hospital
Consultation time】July 2019
Treatment plan】Medication (Levetiracetam tablets)
Treatment Period】Outpatient consultation, followed up after half a month of medication
Effectiveness of treatment】Seizures gradually decreased, and hand dances rarely occurred during sleep
I. Initial consultation
A family member brought their 5-year-old child to the clinic, saying that the child occasionally danced during sleep when he was young, but there was no abnormality when he was awake, and at that time, he was considered to have neurodevelopmental insufficiency, which would improve as he grew older. There seems to be no other abnormalities. The EEG and cranial MRI were recommended to evaluate the intracerebral condition. The cranial MRI was negative and the EEG suggested a small number of sharp waves in both anterior cephalic regions.
II. Treatment history
Benign epilepsy is one of the most common epilepsy syndromes in children, and some children will have seizures during sleep. With growth and development, the brain gradually develops completely, and some children with benign epilepsy can achieve clinical cure without special treatment. The child was given oral antiepileptic drugs, such as levetiracetam tablets, to control the symptoms, considering that the symptoms had not been significantly reduced by the age of 5. The child’s family was asked to come to the clinic for a review in half a month.
Treatment effect
When the child came back to the clinic half a month later for a review, the parents said that the hand-waving during sleep had gradually decreased. Subsequently, the EEG was rechecked and the results showed improvement, indicating that the treatment was working well. The child was advised to take levetiracetam tablets for 2-3 years thereafter to consolidate the treatment and to achieve clinical cure of epilepsy.
IV. Precautions
We are glad that the child’s condition has been effectively relieved by medication, but we suggest that the family still needs to pay attention to the following matters.
1, because the frequent occurrence of benign epilepsy can cause cerebral vascular spasm, brain cell damage, neurological dysfunction, such as memory and comprehension loss, slow reaction, etc., so if such symptoms occur again in the child, it is important to seek medical examination in a timely manner.
2. It is recommended to take levetiracetam tablets as prescribed by the doctor and avoid stopping the drug at will to avoid recurrence of symptoms.
3, to follow the doctor’s instructions to follow-up, timely observation of the recovery of the disease.
4, usually should develop good living habits, exercise, improve immunity, balanced diet, do not picky food, to ensure 8-10 hours of sleep.
V. Personal insight
The symptoms of benign epilepsy may not be specific, as in the case of the child in the article, it only manifests as hand dancing during sleep at night. Many parents will think that it is caused by playing too much during the day and will not think of it as epilepsy, thus delaying the treatment, so it is recommended that parents should pay more attention to their own children in general and seek medical attention if abnormalities appear. If benign epilepsy is diagnosed, and the symptoms are recurrent, and brain function is diagnosed to be decreased, medication should be actively administered. Do not choose not to treat the condition for fear of the side effects of medication, which can affect brain development and cause serious adverse effects.