case_images: PMC9329581_01
case_images: Timeline. (A) The first sibling manifested sequential seizures from the second day of life and up to 15 seizures per day in the next days. He was firstly treated with phenobarbital with partial efficacy, so phenytoin was then trialed and it was effective, but seizures relapsed when blood levels were low due to difficulties in maintaining stable drug concentrations in the chronic stage, especially with oral use, so many blood tests were needed to check blood concentrations. Carbamazepine was finally introduced (5 mg/kg twice) at 2 months of age, obtaining stable seizure control. (B) One year later, a second sibling was born and had a couple of doubtful paroxysmal events on the second day of life suspicious to be a seizure, so an EEG was performed, but it was normal, so she was discharged. Then, at home, new more clear and frequent events suggestive of seizures occurred, so she was again admitted and the VideoEEG monitoring demonstrated repetitive sequential seizures, so, she was treated with carbamazepine as first choice (5 mg/kg twice) with immediate full seizure control and just five days after she was discharged.
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case_images: At home, new more clear and frequent events suggestive of seizures occurred, so she was again admitted, and the video EEG monitoring demonstrated repetitive sequential seizures, so she was directly treated with oral CBZ 5 mg/kg twice a day with immediate seizure control, allowing discharge from hospital in only 5 days (Figure 1B).
case_images: PMC9329581_02