Q: My daughter, 11 years old weighing 38 kg had seizures last month. She has been diagnosed with degenerating cysticercus cyst (colloid vesicular stage) in the right parietal lobe. She has been advised to take Eptoin 100 mg and Frizium 5 mg per day. When we consulted another doctor, he said Eptoin is not good for girls so he wants to shift her on Tegretal. Please advise. How long should these drugs be given? She is doing very well in school, will these medicine or illness affect her intelligence or any other extra curricular activities like dance and singing?

A:Cysticercus of the brain is a very common condition in our country. Patients develop symptoms when the tapeworm cyst starts dying or degenerating. Approximately 60% of patients have a disappearance of cysts by the end of 1 year. The duration of treatment with anticonvulsants will depend upon the presence or absence of the cyst or its dead calcified stage. If the cyst disappears early, we give medicines for 1 year. If however, the cyst persists or leaves a calcified spot (in upto 20% cases) then a 2 years treatment is recommended. The disappearance of the cyst will be assessed by scans. Secondly, I would prefer Tegretal to Eptoin in a female for cosmetic reasons. Tegretal can cause drowsiness in the beginning (hence the dose needs to be increased gradually), which should disappear. Some children can become hyperactive or aggressive. In case these problems are significant, one may require changing the medicine. Usually it does not cause long-term side effects.