Preemie, possible seizures?

Question

My 18 motnh old daughter ( premature, 33 wks, pre-eclampsia, suffered severe withdrawl after birth due to mother's use of Paxil during pregnancy) has been displaying strange behaviors on and off for over 6 months. She will be going about her business and then all of a sudden her face will tense, mouth pulls back, and her head shakes, or tremors. It lasts only seconds, her eyes do not roll, the rest of her body is not involved. She does not appear confused afterwards, or seem to lose awareness when it happens. She has never vomited. At her 12 mth. well child visit, her head measured 1/2 cm above normal, and she was scheduled for an MRI. I took her back to the Doctor before the MRI (15 month well check) and her head measurment was back on the curve. Her pediatrician said that we could hold off on her MRI and see how it measured at her 18 month well check and go from there. We mentioned these "episodes," to her Pediatricain when they started happening, and after discussion she concluded that it didn't sound like a seizure and to keep an eye on her. It seem to stop for short periods, and then return, occuring often, several times a day for a few weeks and then stops again. She is otherwise healthy, developmentally on target. Is it possible that these episodes are seizures even though there is not the usual symptoms along with them? Can an MRI detect that seizures have occured after the fact? I don't know if I am making something out of nothing, but it just doesn't seem right. Could this be a tick? Could it be a lom-term side effect from the Paxil? Has anyone heard of lasting effects on infants/children who's mother's used Paxil during pregnancy? (Besides heart/lung) Any info, advice would be much appreciated!

Lilly8985 · Answer

Thanks for your response!  I spelled "tic" wrong earlier.  Is it possible that the facial tensing is a tic as opposed to seizures?  She has her 18mth well child visit on Jan. 31st, we are hoping to get the Neurolgy referral at that time.  When we first brought up the episodes and her head measurements were slightly off, they were supposed to give the referral then, but instead sent us to a Developmental Specialist, who ordered the MRI, to investigate the head size issue.  As I stated before, her head measurements are back on the curve and she is 100% developmentally on target, if not advanced, verbally.  When I looked up Benign Myoclonus I found that there can be "tactile and acoustic," triggers.  Often these episodes have happened while she's eating, Is it possible for food texture to be sfizure trigger?  That just seems so odd!   Thank you again for your advice and info!

JainMD · Answer

Hi,
Yes it is indeed possible that it can be due to seizure. Seizures in children shows up with very subtle signs like uprolling of eyes, jerky movements, lip smacking, absence of normal play for few secs while playing etc.
But these type of seizures need to be picked up with help of EEG, more appropriate for this child might 24 hours EEG.
No MRI cannot detect if the seizures have occurred or not.
What do you mean by tick?
No these can't be long term effect due to Paxil, I have not come across any literature.
Only other possibilities are Benign Myoclonus of childhood or infancy.
Keep me informed if you have any other queries.
Bye.