A seven-year-old boy diagnosed in the Neurology Department of the referral hospital with secondary epileptic encephalopathy (bilateral perisylvian polymicrogyria), West syndrome with transitional evolution to Lennox-Gasta syndrome
Subsequent studies confirmed delayed psychomotor development and hypsarrhythmia, which led to the initiation of treatment with adrenocorticotropic hormone (DH), valproic acid, levetiracetam and zonisamide.
This time, anticonvulsant treatment guidelines have been modified according to their evolution.
Given its poor response to multiple treatment, it was decided to make an adjuvant ketogenic diet.
During the same time, urine calcium levels increased (previously already had hypercalciuria), so in the referral hospital they were referred to the Nephrology Department.
Parents refused to go because they were tired by multiple specialist consultations and requested to be seen by their pediatrician in the health center.
