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Ictal vomiting

A young boy with recurrent vomiting followed by headache for four years. Repeatedly evaluated for gastric, liver and kidney diseases. Neurological examination normal. No history of fits.

MRI brain showed hyper intense frontal cortex on DWI.

Ictal Vomiting - clinical image 2 of 5

Ictal Vomiting - clinical image 3 of 5

EEG showed frontal spike with generalized discharges in HV.

Ictal Vomiting - clinical image 4 of 5

Ictal Vomiting - clinical image 5 of 5

Suspected ictal vomiting. Treated with Levetiracetam. Patient asymptomatic on followup visit.

Doing it properly

Little and often beats one long session. Keep to the stated frequency for at least two weeks before judging whether it is helping, and stop any movement that causes sharp pain rather than working through it.

Come in if

Symptoms are worsening, waking you at night, spreading to a new limb, or unchanged after four weeks. Walk in during clinic hours — Monday to Saturday, 11:00 am to 06:00 pm — and bring this guide and any reports with you.

A question about your own case is better answered by the doctor than by a guide. Message the clinic with your name and file number.

General education, not a prescription. Seek urgent care for sudden weakness, slurred speech, a first-ever fit, a face that has drooped, or the worst headache of your life.