Roxey came to hang out with me at the hospital tonight and was on “bum pat” duty just after Jared left (around 11:30p). Charlie opened his eyes with a wide-eyed glassy blank stare, held his breath, limp body except for a single near lurch and pooped at the same time. He had beads of sweat immediately rather than his usual working up to sweating. This lasted for about a minute then he got a little agitated but calmed with the bum pat. We moved him to the crib to change his diaper and then got him comfortable on his side in case he threw up. Then his left eye started twitching to the left (nystagmus) for a few seconds and then stopped. His body never jerked or stiffened throughout any of these and vital signs remained normal (BP114/67). He had a couple more episodes of left eye twitching and one more episode of blank stare without blinking and then fell into a deep sleep (post-ictal). My impression is that it was an absent seizure. The whole series of events lasted less than 30 min. The doctor was paged and he approved the seizure dose of Ativan to be given but by that time Charlie had stopped so we opted not to give it. He is currently on 3 seizure drugs (although one isn’t being used for seizures) and they were given at 8:00 so I think we will be seeing Dr. Filloux (neurologist) tomorrow for another consult. Charlie has had seizures two other times during this hospitalization- first in the PICU when his brain was so swollen and then second when we had just transitioned to the neurotrauma unit 2 months ago. Both of these first episodes he was jerking and stiffening his body. I guess it’s a good thing we are still in the hospital. If we had been home we probably wouldn’t have been holding him while he was sleeping so calmly.
Morning Update: He slept from 12:00-5:00 and then was irritable due to gas. Dr. Such-Neibar and the resident Dr. Henrie came in to get the details of last night's events and tell me the plan. They will notify the neurologist and draw a blood level to see if his medication is high enough. She will also talk to neurosurgery about Charlie's brain CT from yesterday. It looked the same as before (ventricles are still huge, but not under pressure). Charlie is a little confusing to them because he is improving in certain things-controlling his head a little more, sucking, opeining eyes more- but degressing in other areas-agitation, seizures. Dr. Such-Neibar said that is not normally the way brain injuries go. But when has Charlie ever gone about things normally?