Q: My 6 years old nephew is suffering from cerebral atrophy due to which he is having epilepsy and has weakness in one part of body. His one hand and a leg are not working to full potential though he is able to walk. He understands everything but is unable to speak. He can make us understand what he wants to say through sign language. Can his condition be treated? Will he ever be able to speak?

A:Your nephew suffered an event at birth or subsequently which resulted in hemiplegia and possibly a gliotic area or porencephaly in the brain. An additional morbidity is epilepsy.

I would like to think that he has received intensive occupational therapy since his illness was detected. And was speech therapy started at 2-3 years of age?

I would recommend a development and hearing assessment of this child. Additionally, a sleep EEG should be done to see if he is having frequent epileptiform discharges. In that case, adjusting the anticonvulsants, use of steroids may help. He should undergo speech therapy and remedial education.