Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Seizures and Dilantin

Forum: Neurology Forum
Topic: Neurology - General


My mom is 77 years old and in December and February she had fallen, no one was around when she fell but she was found on the floor, very disoriented. In March the CT scan found that she needed a shunt put in her brain to drain the excess fluid out. They said at that time that she had probably always had this from childhood. So they put in a medium flow then found that it was draining too fast and put in a slow one in April. Now July 22 she had what we thought to be a stroke and a few hours later she had a seizure. She went to the hospital and they did another CT scan and it showed no difeerences from the last one she had. So no stroke but they want to put her on Dilantin to control the seizures. We were told that the reason for the seizures is because of the shunt and protons bouncing off it. Could this be true? Will she always be soo drugged up that she doesn't interact? What are the side effects? Should the shunt be taken out?
Please help me understand!
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Dear Lisa,

Your mother probably had a shunt placed for a condition called Normal Pressure
Hydrocephalus, or NPH. This is a condition of primarily elderly patients where
the ventricles in the brain are large. It manifests as the classic triad of
dementia, instability of gait (ataxia) and urinary incontinence. All of these
need not be present for the diagnosis.

It is unclear whether and, if so, why your mother had a seizure. The presence
of a shunt should not, in itself, cause seizures. Things to consider would
be stroke, electrolyte imbalances and medications for starters. If your mother
did indeed have a seizure, it is reasonable to start Dilantin to prevent further
seizure activity. The remaining question is why she seized. Apparently the
CT scan was negative, which helps but does not explain the seizure.

Speak to your mother's physician for a clearer explanation of what they think
is going on. If you don't understand, ask again for answers in simpler terms.
You need more information clearly presented so you can make educated decisions
regarding your mother.

Good luck.

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