Oral phenytoin- Pediatric Oncall

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Gurmeet Singh, Reena Sood Department of Pediatrics and Department of Obstetrics and Gynaecology, Sh...

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	Specialist Answers
Question
A 7yrs old child a known case seizure disorder was on oral phenytoin from some local practioner for one year,seven months back he had a episode of gen seizure and was in status. was managed conservatively and was noticed that he was having inadequate dose of phenytoin.A repeat EEg was done which showed a seizure activity,neuroimaging was normal study.HE was started on sod;valporate in stead of phenytoin ( valporate dose-25mg/kg/day),he remained seizure free for seven months after that but now again had a gen;seizure but not status. do i need to start any other add on drug like Lamotrigine? I simply increased the dose of valporate to (30mg/kg/day) with which seizures are well controlled.
Answer
You may get TDM levels of valproic acid and if it is low, doses can be adjusted. Since the child was seizure free for 7 months, it is unlikely, that additional drug will be required. Back to All Questions

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