Assalamo Alaikum!

From what you tell me, (paranoia, visual hallucinations etc) the child seems to have a dominant temporal lobe stroke (or even a TIA) extending deep into the thalamus maybe (painful episodes, behavioral episodes) or it could be a kind of temporal lobe epilepsy (as it is all episodic) but this may also be a purely psychiatric condition.

The information you have given is too little to make any definite opinion. To make a diagnosis, one needs to examine the child in detail to see the kind of deficits that the stroke has caused as well as need to look at the MRIs. Generally possible strokes involving clots do not show anything on MRIs or CT scans in the first few days etc or if they are really minor and reversible (like in a condition called TIAs). The changes take from a few days (on MRI) to a few weeks (on CT) to be apparent. These scans are also normal in epilepsy, in which case EEGs are needed.

I am sure the doctors at Agha Khan Hospital are doing their best. However do let me know what they think it is when they come up with a diagnosis.

Allah hafiz
Nasir