[4F] With seizures, eye and throat pain, and elevated alkaline phosphatase

Question

All these symptoms are progressively worsening seizures began in July and so did elevated liver enzymes. She seems to progressively be getting worse with no diagnosis to why. MRI is scheduled but a mo th out. Any help to try and figure if these things correlate to something bigger

Patient Description

A 4-year-old female is experiencing right eye pain described as sharp with watering, and throat pain characterized by pressure, primarily on the right side with bilateral lymph node swelling. These symptoms began after starting Tryliptel, with worsening eye pain upon dosage increase. The patient underwent a tonsillectomy approximately one month ago. She also has a history of nocturnal left frontal lobe seizures, occurring nightly with multiple episodes, confirmed by an EEG showing six seizures. Associated symptoms include emotional changes, clinginess, increased agitation, periodic hyperactivity, and irritability. The patient has experienced a loss of appetite for over six months, with fluctuating weight, not exceeding 37 pounds since age three. Elevated alkaline phosphatase levels have been noted for the past four months, with worsening levels. Liver function tests are also increased. The patient has a history of asthma diagnosed last year and multiple episodes of right-sided upper lobe pneumonia. No recent infections or illnesses post-tonsillectomy have been reported.

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Arora's Assessment

What might be happening

It sounds like there are several symptoms and conditions affecting your child, which may be related to multiple underlying issues:

  1. Eye Pain and Pressure: This could be a side effect of Tryliptel, especially since it started after the medication was introduced. It's important to discuss this with your doctor, as they may need to adjust the dosage or try a different medication.

  2. Throat Pain and Swollen Lymph Nodes: This might be related to the recent tonsillectomy. Post-surgical inflammation or infection could cause these symptoms. Monitoring for any signs of infection, such as fever, is important.

  3. Seizures: The left frontal lobe seizures, especially occurring at night, are concerning and need ongoing management by a neurologist. The EEG results showing multiple seizures indicate that the current treatment plan may need adjustment.

  4. Elevated Alkaline Phosphate and Liver Function Tests: These could indicate liver stress or other metabolic issues. It's important to follow up with your healthcare provider for further evaluation.

  5. Fatigue and Loss of Appetite: These symptoms could be related to the medication, seizures, or another underlying condition. They may also be contributing to the weight fluctuations.

What you can do

Eye Pain and Throat Pain:

  • Continue to monitor these symptoms and report any changes to your healthcare provider.
  • Ensure your child stays hydrated and consider using a humidifier to ease throat discomfort.

Seizures:

  • Keep a detailed log of seizure activity, including frequency and duration, to share with your neurologist.
  • Ensure a safe environment to prevent injury during seizures.

Elevated Liver Tests:

  • Follow up with your healthcare provider for further testing and evaluation.
  • Avoid any medications or substances that could further stress the liver.

Fatigue and Appetite:

  • Encourage small, frequent meals to help with appetite.
  • Ensure your child gets adequate rest and a consistent sleep schedule.

What you should look out for

  • Any signs of infection, such as fever or increased swelling.
  • Worsening of seizures or any new neurological symptoms.
  • Significant changes in behavior or mood.
  • Any new or worsening symptoms should prompt a visit to your healthcare provider.

Remember, it's important to work closely with your healthcare team to address these complex symptoms. Using MDandMe to journal symptoms and track progress can be helpful in managing your child's health.

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7 mo ago

People Also Ask


Can Tryliptel cause eye pain and what should be done if it does?

Yes, Tryliptel can cause eye pain as a side effect. If this occurs, it's important to discuss it with your doctor, who may adjust the dosage or consider an alternative medication.


What are the potential causes of swollen lymph nodes after a tonsillectomy?

Swollen lymph nodes after a tonsillectomy can be due to post-surgical inflammation or infection. Monitoring for signs of infection, such as fever, and consulting with a healthcare provider is recommended.


How can nocturnal seizures in children be managed effectively?

Nocturnal seizures in children can be managed by working closely with a neurologist to adjust medication and treatment plans. Keeping a detailed log of seizure activity and ensuring a safe environment are also important steps.


What could elevated alkaline phosphatase and liver function tests indicate in a child?

Elevated alkaline phosphatase and liver function tests in a child could indicate liver stress or other metabolic issues. Further evaluation by a healthcare provider is necessary to determine the underlying cause.


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2 Comments


Arora (Bot)#28060

7 mo ago

I'm sorry to hear about the challenges your child is facing. The combination of symptoms like seizures, elevated liver enzymes, and other issues could potentially be related to a systemic condition or a reaction to medication. Here are a few possibilities to consider discussing with your healthcare provider:

  1. Medication Side Effects: Tryliptel could be contributing to both the seizures and liver enzyme elevation. It's important to review this with your doctor.

  2. Metabolic or Genetic Disorders: Some conditions can affect multiple systems, leading to neurological and liver issues.

  3. Infections or Inflammatory Conditions: Post-surgical infections or other inflammatory processes might be contributing.

  4. Autoimmune Disorders: These can sometimes present with a range of symptoms affecting different organs.

While waiting for the MRI, continue monitoring symptoms closely and keep detailed records to share with your healthcare team. This can help in identifying patterns or triggers. If any symptoms worsen significantly, consider seeking more immediate medical attention. Working closely with your child's healthcare providers is crucial in managing these complex symptoms. If you have any more questions or need further assistance, feel free to ask.

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Anonymous#61607

7 mo ago

Can you elaborate in more detail of what metabolic conditions and or genetic disorders. And also autoimmune disorders that would have all these symptoms

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