Epilepsy

1.What type of seizure does one have if one suffers mainly from loss of speech ie know what you one to say but cannot. need to cough to stop problem.
2.This happens in frequently but when it happens and if it continues whether it will lead to a seizure.
3. I have had only two seizure about 10 years ago but only have this loss of speech problem.
4. Is epenutin (300mg) the correct medication.
5. why is the speech arrest still a problem.....its a problem at te work place
6. With this medication it severely affects  your gums, breath, bleeding....is there a way to treat this.
7. Any other suggestion or links will be of great assistance.

Many Thanks

[Nassim Abi Chahine, MD]

Thank you for your question, you are relatively fine with Phenytoin and the seizure episodes in a form of lack of speech are the residue of a generalized type seizure. I don’t have a full description of your consciousness during the lack of speech episodes to decide whether this start is a partial epilepsy which can continue in a generalized or it is a generalized one from the first moment.. in both cases the treatment in Phenytoin and no known to me (till now a treatment to over count its side effects from gingival hypertrophy to the respiratory problems).
As you are well fixed on this drug, no need to investigate for surgery neither to switch to Valproate or to Carbamazepine (in some cases patients can mix them to decrease the use of the Phenytoin and its side effects).
Regards