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For how long do I need to take Eptoin for convulsions?

Q: I am a 40 years old man, weighing 55 kgs and 5.4 in height. Four months back I was attacked by a stray bull in Delhi and had a head injury measuring about two inches on the right side of the head. Immediately, I was taken to AIIMS and was given first aid followed by metallic stitch. I was conscious at that time and there was no vomiting except giddiness. I was not admitted in the hospital. The head scan shows no damage to the brain. Next evening I got severe body pain. I am a regular at Yoga. Thinking that some Yoga may give relief, I practiced pranayam and I was alright. After one hour when I was talking to a friend, I got a convulsion and was fine in 45 minutes. I have never had a convulsion earlier. Now I am alright but I was asked to take Eptoin-100 three tablets per day. For the last four months I am taking this regularly. Initially doctor told that Eptoin should be continued minimum for a period of six months. When I consulted him yesterday, he said that this tablet should be continued and the minimum course is for three years. Is it true? One neurosurgeon said that it is minimum for a period of six months and other says three years which is correct? As I am working in an office I feel little uncomfortable with this tablet. For this he told me to take all the three tablets (100 mg x 300 mg) at one time at night. Will it be OK? I have not had convulsions again and am doing well. How long do I have to continue this drug? Can I practice Yoga? Did I get an attack due to Yoga?

A:Eptoin is the brand name of a medicine called phenytoin sodium. Its dose is 3 to 4 mg per kg of the body weight. For your weight of 55 kg, the dose of 200 mg a day is more than sufficient. You can take two tablets of 100 mg each just once at bedtime. In India, there are wide variations in the prices of the same medicine by different companies. Epsolin brand is 40% less expensive. It is manufactured by Cadila, one of the top 10 drug companies of India. Most unfortunately prescribing doctors do not pay attention to the price factor, particularly in cases where the medicine is to be taken for long duration. The duration of treatment your doctors have suggested is for patients of epilepsy. Your case is somewhat different even though the medicine remains the same. I should think that six months of phenytoin sodium 200 mg (Epsolin) per day should be adequate. Yoga could not be responsible for seizures in your case. In all likelihood, there was some minor trauma/microscopic bleeding into the brain which would not become obvious on the scan. You can certainly continue with Yoga.

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