1. We agree with the author’s contention. Two of
the cases had secondary generalization, as mentioned in the original
article also [1].
2. Three infants had a normal MRI brain (1.5T),
whereas, due to financial constraints, one child underwent a
non-contrast CT head. Normal neuroimaging had been mentioned in the
original article [1].
3. We are unclear about what the authors mean by
a metabolic and a genetic work-up. There is no single
metabolic/genetic panel that may be ordered in all children with
seizures. We followed standard guidelines for evaluation; metabolic
profile to rule out inborn errors of metabolism was done only when
indicated on the basis of history or examination findings, or
results of other investigations. Genetic testing was only done, if
there was a suspicion of a disorder on the basis of dysmorphology,
seizure semiology, family history, and associated clinical findings.
Otherwise, genetic testing is likely to be a low-yield strategy.
4. We agree that we should take a directed
history of diarrhea in infants with clusters of seizures. None of
these had such a history. In fact, we have previously reported one
patient with Benign infantile seizures with mild gastroenteritis,
who was diagnosed during the same study [2].
5. We agree that a definite diagnosis may only be
possible later; however, most of the literature is still of the view
that treatment with anti-epileptic drugs is not mandatory [3]. In
fact, in the study referred to by the author [4], the definite
diagnosis could be made for more than three-fourth of those
initially diagnosed as having ‘possible’ Benign partial epilepsy of
infancy. The ‘possible’ terminology; however, has no scientific
sanction.