Case summary: Kevin.

Kevin suffered a severe Reye's encephalopathy at the age of 11 weeks which left him severely brain damaged. Simple partial seizures started in the recovery phase and were controlled by carbamazepine. He went on to develop symptomatic infantile spasms that were controlled by the addition of clonazepam. He became progressively microcephalic and investigations confirmed cortical blindness and left hemiparesis. Subsequent seizure types included absences and troublesome generalized myoclonic seizures. Now almost six, he attends a special school and is well controlled on a regimen of sodium valproate, clonazepam and lamotrigine.