Discussions By Condition: I cannot get a diagnosis.

Son 4 years old...."dying spells" HELP

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: Shannones
  • June 16, 2009
  • 02:40 AM

I really need help. I know SOMEONE knows what is going on with my son. We have seen countless doctors about these "spells" however no answers. We even spent 88 days inpatient last year at a TOP hospital trying to get to the bottom of them but to no avail. I know that someone out there has seen this before, I just need to find them.

We have has EEGs, EKGs, contrast bubble study, echos, MRIs, CT of chest, ph probes, botox in saliva glands.....all with no answers.

When my son does these episodes his sats we have seen as low as 11. Oxygen doesn't help. He also has done them while intubated/sedated.


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2 Replies:

  • I'm sorry to hear that your little one is having problems. First I would suggest that you update your post, you've given alot of info on tests, but very little description as to your son's symptoms..breathing complications? rapid heartbeat? change in skin color? temperature? seizure? low/high blood pressure? Vomiting?....Please tell us what happens during these "spells". The more details we have the more informed we can be, & hopefully we can help you & your son feel better..Wishing you well-being & helpful correct answers...Becca318
    Becca318 13 Replies Flag this Response
  • Thank you for providing the video account of what is obviously an example of the "spells" for which you are seeking to indentify the cause. When observing the infant in the obtunded state on the video, I would ask you at what point the episode actually began by relation to the video and generally what takes place to alert you that something is wrong. I note a rather abrupt and transient instance of mydriasis with anisocoria, which simply means that the pupils dilate very dramatically and the right eye in this video instance becomes enlarged to a greater extent than the left. Of particular note, this type of ocular response would be entirely inconsistent with the presence of light as shown in the video and to some extent, tells a great deal about what's happening during the episode. Realize that in instances of mydriasis or anisocoric features combined, the usual causative factor relates to 3rd cranial nerve palsy or compression and since we have a history which would rule it out, we have to consider other possibilities. The other features of the child, particular expression, would initially suggest focal seizures and the case where it would affect the pupils to the extent described, would be located in the left frontal region of the brain. The ocular phenomenon has been observed in several instances where something called Todd's Paralysis occurs, which is basically a hemiparalysis that appears in the refractory period of left frontal seizures, but it would not resolve as quickly as in the video example. In any instance, the level of thoroughness in EEG testing described by you would have ruled out this type of seizure disorder. The other consideration here is a state of brief cerebrovascular hypoxia that would induce the mydriatic and anasocoric manifestation, which would be consistent with O2 saturations of the level described. In the video, there is a transient cyanosis which takes place as well, if but brief, and would suggest the possibility of laryngospasm, or spasm of the glottis. This typically occurs only in infants, but if unidentified and untreated, can persist for several years. With this in mind, I also note that no vocal expressions and or regurgitary instances are observed until changes take place that would indicate the episode is resolving. This would be the case in a laryngospasm, wherein nothing goes in or out. Such spasms, depending upon whether they are inspiratory or expiratory, are sometimes preceded by sighing or a crowing sound as the episode commences, but this is not always the case. Without the aid of actual test results of everything evaluated in your child, this would be about the most I can offer at this point. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
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