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Neurology (Expert Forum)
Re: Seizures and Dilantin
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Re: Seizures and Dilantin
by CF-Neurology, Jan 01, 1995 12:00AM
Posted By CCF Neurology* on April 19, 1998 at 16:18:25:
In Reply to: Seizures and Dilantin posted by Pat on April 19, 1998 at 15:08:13:
My husband has been having occasional seizures as a result of Cerebral Vasculitis (diagnosed in the fall of 1996). He is taking Dilantin to control the seizure activity. The latest incident occurred yesterday while we were outside gardening. Prior to that, the last seizure was in early December. My questions are:
1. Is there a recommended schedule for bloodwork to test Dilantin levels?
2. What factors change the Dilantin levels in the blood?
3. Are there any known triggers for seizures?
4. Is there anything he (we) can do to prevent the seizures from occurring?
5. I have been told the seizures are a result of "electrical" activity in the brain - but I don't understand why or when this would happen.
This uncertainty of not knowing when or where or why makes everything very difficult. Any suggestions or information would be appreciated. Thanks!
Dear Pat,
A seizure is the clinical manifestation of an excessive discharge of a group of brain nerve cells (neurons). As such, a seizure can be a reflection of virtually any pathologic state that alters the structure (as probably occured during the vasculitis) or biochemistry of the nervous system. There are several seizure patterns based on the location of the underlying abnormality and the spread of discharges over the brain. Epilepsy is defined as the tendency to have recurrent unprovoked seizures. This is a chronic condition for which long-term medication is often warrented. People who have epilepsy are prone to seizures, that is , despite optimal medicaitons they still may have "breakthrough" seizures. There is no way to predict when a seizure will occur. There is a lower seizure threshold in patients who become acutely ill, sleep deprived, fail to take meds regularly. The medications are used to decrease the frequency and often the severity/spread of seizure activity to other parts of the brain. There are certain individuals who are candidates for surgery to resect the abnormal parts of the brain if they have not gained adequate seizure control with medications (sometimes they become seizure free after such procedures). Dilantin is a popular medication used to treat epilepsy. The indications for monitering drug levels include:use of drug with a narrow therapeutic range, noncompliance, failure to obtain adequate seizure control, symptoms of toxicity, suspected drug interactions, alter drug metabolism secondary to another disease or change in physiological state (such as infections etc.), need to define blood levels associated with the optimal response. Exluding all factors above, the dilatinin level should be followed every couple of months. During the time of any dose changes, the levels should be monitered more closely. There are several medications that can either increase or decrease the dilantin level. They are too numerous to list. If you are concerned about a particullar medication as your doctor about drug to drug interactions. The dose of the Dilantin may need to be increased or decreased accordingly. Both the free and total dilantin levels should be monitered. If you are interested in getting an evaluation by a neurologist at CCF who specializes in seizure disorders, call 1-800-CCF-CARE. Good Luck.
In Reply to: Seizures and Dilantin posted by Pat on April 19, 1998 at 15:08:13:
My husband has been having occasional seizures as a result of Cerebral Vasculitis (diagnosed in the fall of 1996). He is taking Dilantin to control the seizure activity. The latest incident occurred yesterday while we were outside gardening. Prior to that, the last seizure was in early December. My questions are:
1. Is there a recommended schedule for bloodwork to test Dilantin levels?
2. What factors change the Dilantin levels in the blood?
3. Are there any known triggers for seizures?
4. Is there anything he (we) can do to prevent the seizures from occurring?
5. I have been told the seizures are a result of "electrical" activity in the brain - but I don't understand why or when this would happen.
This uncertainty of not knowing when or where or why makes everything very difficult. Any suggestions or information would be appreciated. Thanks!
Dear Pat,
A seizure is the clinical manifestation of an excessive discharge of a group of brain nerve cells (neurons). As such, a seizure can be a reflection of virtually any pathologic state that alters the structure (as probably occured during the vasculitis) or biochemistry of the nervous system. There are several seizure patterns based on the location of the underlying abnormality and the spread of discharges over the brain. Epilepsy is defined as the tendency to have recurrent unprovoked seizures. This is a chronic condition for which long-term medication is often warrented. People who have epilepsy are prone to seizures, that is , despite optimal medicaitons they still may have "breakthrough" seizures. There is no way to predict when a seizure will occur. There is a lower seizure threshold in patients who become acutely ill, sleep deprived, fail to take meds regularly. The medications are used to decrease the frequency and often the severity/spread of seizure activity to other parts of the brain. There are certain individuals who are candidates for surgery to resect the abnormal parts of the brain if they have not gained adequate seizure control with medications (sometimes they become seizure free after such procedures). Dilantin is a popular medication used to treat epilepsy. The indications for monitering drug levels include:use of drug with a narrow therapeutic range, noncompliance, failure to obtain adequate seizure control, symptoms of toxicity, suspected drug interactions, alter drug metabolism secondary to another disease or change in physiological state (such as infections etc.), need to define blood levels associated with the optimal response. Exluding all factors above, the dilatinin level should be followed every couple of months. During the time of any dose changes, the levels should be monitered more closely. There are several medications that can either increase or decrease the dilantin level. They are too numerous to list. If you are concerned about a particullar medication as your doctor about drug to drug interactions. The dose of the Dilantin may need to be increased or decreased accordingly. Both the free and total dilantin levels should be monitered. If you are interested in getting an evaluation by a neurologist at CCF who specializes in seizure disorders, call 1-800-CCF-CARE. Good Luck.
