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What leads to recurrence of seizures?

Dr RK Sabharwal
Senior Consultant, Child Neurology & Epilepsy,
Sir Ganga Ram Hospital,
New Delhi

Q: My 9 years old daughter is 4.6 feet tall and weighs 40 kg. She has been suffering from seizures for the last two years. Last year, she got a mild attack and saliva came out of her mouth. Her left hand was also shaking. She was put on Phenytoin for some days after which she developed allergy to it. Then the doctor prescribed Oxetol SR (300 mg) for her. She was doing fine with this medicine but a few days back she got another seizure attack, which lasted for a few seconds. The doctor increased the dosage of Oxetol SR to 450 mg. But this hasn't helped much in controlling the seizures. The doctor has now prescribed Levesam (250 mg) along with Oxetol SR (450 mg). What can the reason for recurrence of seizures? Is it due to increase in my daughter's body weight? Further, her breast development has also started. Is this because she on the onset of menstrual period?

A:The recurrence of seizures in your child's case could be due to inadequate levels of Oxetol. The dose of 450 mg/day that you are giving is inadequate as regards her body weight. I would suggest increasing the dose of oxetol to 300 mg twice daily for 10 days. Then you could increase it to 300 mg in morning and 450 mg at night. Do not miss the medicines and give it at regular at every interval of 12 hours. I would not start Levesam yet.