Q. My son is 16 months old. The doctors say
that he shows some autistic traits. For this, he is going to have a
brain scan using MRI and he will be sedated. Are there any risks involved
in this? What will the brain scan effectively show?
A. Usually the sedation used for MRI scan is safe and
the scan is being done to find out if the autistic behaviour is associated
with any underlying lesion in the brain.
is the cause of severe pain in the neck and whirling sensation?
Q. My wife is suffering from pain at the
back of the neck on the right side. The pain starts behind the right ear
and continues up to the back of the neck's right side. At times she has a
whirling sensation and complaints that everything around her is revolving.
Her right ear has a sensation of fullness, which irritates her. Couple of
months ago, this was also associated with severe headache and occasional
vomiting. She is very depressed with all these problems. Our family physician
diagnosed it as vertigo and prescribed Vertin 16mg three times a day during
severe conditions. He also suggested Betacap 40 TR, Tryptomer 25mg one each
a day for a month. The headache stopped after this. Then the doctor asked
her to reduce the dose of Vertin gradually to 8 mg a day for over 2-3
months. He also suggested stopping it if there is no problem. She stopped
for a month because she had none of the above problems. After stopping,
similar symptoms appeared again, but without the headache. The doctor
prescribed Vertin again, but there was no relief. She consulted an ENT
specialist, who suspected frontal sinusitis & took a CT scan. Although
the CT scan report shows normal, the doctor suggests a surgery to rectify
the frontal sinusitis. We consulted another ENT specialist, who referred us
to a neurologist. The neurologist attributed all the symptoms to a kind of
migraine, suggesting the following medicines for a month - Zapiz
(Clonazepam) 0.25 mg during nights, Trilol SR-40 (Propranolol HCL) 1/2 each
in the morning & night, Libotryp (chlordiazepoxide & amitriptyline
hydrochloride) 1 during nights. It has been a week since she has been
taking these tablets, and we are waiting for the effect of these. Now we
are confused whether to go to a physician, ENT specialist or a neurologist.
Please suggest a suitable medical treatment for the above problem.
A. Vertigo (which is commonly described as spinning,
rotating or dizzy sensations) can have many causes and migraine is
certainly one of them. However, when associated with migraine, it is
closely related with headache. Your symptoms of severe headache and
vomiting (especially if pulsatile) raise the possibility of migraine and
the close temporal association of vertigo with it can be explained by
migraine itself. In that case your wife is likely to benefit from
preventive treatment of migraine, which has been advised.
However, as I have mentioned earlier, vertigo can be due to other causes as
well and therefore these need to be excluded. This is particularly true if
the vertigo is present with new onset headache (that is, the headache which
your wife experienced started only recently and previously there was no
history of headache) and more so when vertigo is occurring without headache
(as is the picture now).
Frontal sinusitis is unlikely to cause vertigo. It can cause headache but
that is usually frontal and not at the back of head. Evidence of sinusitis
can be found on CT in many normal persons and only becomes significant when
it can be correlated with clinical symptoms.
Vertin is an anti vertigo agent with specific indications and not to be
I think you should consult a good neurologist.
is the cause of seizures when the brain is normal?
Q. What are focal seizures? My son is 4 years
old and he is autistic. He had seizures once and after a month he had
seizures again. His MRI is absolutely normal with no complications.
Hence the cause of seizures could not be detected. He has been put on
anti-convulsant drug (tegrital syrup) for about 2 years. If we stop the
drug, will the seizures stop forever? What could be the cause of seizures
as MRI is normal? Can forceps delivery be the cause of autism?
A. Focal seizures mean that convulsions or fits do not
involve the whole body but only a part of it e.g. one arm or one leg or
facial twitchings, etc. Usually they are not associated with loss of
consciousness. MRI only tells us that the brain is normal structurally. EEG
may be able to tell us whether there is any abnormal discharge from the brain
responsible for convulsions. If the child is seizure free for 2-3 years, is
neurologically normal and EEG is normal then gradually anticonvulsants can
be taken off and most of the children will not have recurrence of seizures.
Meningitis at 2 months could be the cause of seizures and abnormal
neurological behaviour. I don't think forceps delivery can cause autism.