A female 11 year old patient has episodic difficulty in breathing & speech lasting for 20- 30 min. during the episode her oxygen saturation goes down to 50-60%. she can cough but can not produce '' Aaaa'' sound. All this happens in waking hours only. She is not taking food appropriately, She chews the food & then discard in polythene bag. she keeps on spitting in hanky.
She is lean & thin can not remain upright on her own. Some times she expresses suicidal ideas, but there is no attempt till now. All these problems are for last 2 years. Kindly suggest me how to proceed in this case?
