Hi there, and thanks for your question. I reviewed your text above, as well as the MD's responses, and I thought I'd add a few things. I trained in Southern California, and I'm pleased to hear that you're being treated at CHOC -- it's an excellent place with great doctors, and I hope they help figure things out. In reviewing your comments, I thought I'd offer a few conditions that are associated with seizure-like activity and eye movements. I agree with the other Pediatrician, it's important that you see an Pediatric Ophthalmologist. Nonetheless, here are a few conditions that can occur in 7 month-olds, and are associated with normal EEGs:
Spasmus nutans consists of a triad of symptoms including nystagmus
, head nodding, and head tilt. The symptoms can wax and wane during the course of the day and, therefore, be confused with epileptic seizures. The onset of the symptoms is usually during the first few months of life. The cause of this disorder is unknown, although the triad has been associated with mass lesions at the optic chiasm or third ventricle. A head MRI scan should be obtained in these infants. Since you had one already, that is reassuring. When no abnormality is revealed, no further work-up or treatment is required. The symptoms usually resolve by age 5 years.
Oculomotor apraxia is a condition in which the child has impaired rapid eye movements. The child appears to have fixed eye positions although the visual system and eye movement ability are normal. Therefore, in order to view an object, the child will turn his head suddenly so as to move the direction of gaze. These peculiar head thrusts may be confused for epileptic seizures. The familial form of this apraxia is called Cogan's oculomotor apraxia. However, oculomotor apraxia can also be seen in other conditions like ataxia telangiectasia and lysosomal storage diseases.
Stereotypic behaviors are repetitive movements such as head banging
, head rolling
, body rocking, and hand flapping. These behaviors can be seen in normal children but are more common in neurologically impaired infants. The behaviors may be seen while the child is awake, falling asleep, or even in early sleep stages. These behaviors are "self-stimulating" behaviors and often comfort or relax the child.
These are just a few additional possibilities. Obviously it's difficult to assess and evaluate your child online, but I'm glad to hear you're at a good facility. Feel free to ask any additional questions, and if you are satisfied with my answer, please click 'Accept.' Take care, Dr. Davidson