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Does my son need a CT scan?

Q: I have a 10-year-old son. He is healthy and has good eating habits since his early childhood, but is a little fat. When he was 2 years old he fell down running and hit is head on the floor. He was unconscious, but recovered after a few seconds after water was splashed on his face. Then at the age of 5 years, he fell down from a cot hitting his head on the floor. He was unconscious and some white bubbles started coming out from his mouth. However, he recovered after water was splashed on his face. Then at the age of 9 years, he fell down while walking backwards. After half an hour he got fits and became unconscious, and some white bubbles started coming out from his mouth. But again on splashing water he recovered. In all these incidents, there was no external injury or bleeding in any part of the body. But since the past one year, he is having problems with his vision. We have consulted the doctor and he is using opticals. Other than this, he is healthy. I am afraid that since he has not undergone any CT scan so far, there could be a problem when he grows. Should I get the CT scan or any other scans done?

A:Your child has had episodes of loss of consciousness related to injurious falls. The cause and effect relationship has to be established. Did he lose consciousness immediately prior to falling, or was it after the fall and injury? Children, sometimes, are known to lose consciousness after an injury or a knock on the head, or after a fall. They become pale, stiff and may even have a convulsion with frothing. These are called non-epileptic convulsions or reflex anoxic seizures, and result from slowing of the heart and decreased blood flow to the brain. Generally, no treatment is required in such cases. On other occasions, seizures may result from head injury (concussion) as a result of the fall. Generally, the fits that occur immediately or soon after the fall, in which the child recovers fully after the fit, are not dangerous as compared to fits that occur days after a head injury. These are rules of the thumb and each patient has to be judged individually. Though I suspect reflex anoxic seizures in your child, I would recommend that you meet a neurologist who will take a detailed history, and cross-examine the eyewitnesses. He may want to get an EEG and CT scan of the brain done, which I would consider reasonable.

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