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Posted On : 26 Apr 2011

a3year old child who presented to me with aprolonged non febrile seisure ,he received 3 doses of Diazepam and still fitting ,therefore i started astat dose of Phenytoin 15 mg per kg after which he had settled and seizure stopped ,and maintained on Phenytoin 5 mg per kg per day, should he be kept on Phenytoin after discharge and for how long ,and which is better to start with in such cases phenobar. or phenytoin, tell me the appropriate management of such cases. thank you.

Expert Answer :

Answer Discussion :

D

dr.ankur patel

0

phenytoin given for 5 days and plan for eeg to rule out epilepsy.....

13 years ago

V

vinod sharma

0

pl investigate first

13 years ago

T

T Jothi

0

do investigations -ct scan of cranium,e.e.g.,metabalic screening before discharge if you are able to find the cause treat the cause. if all the test results are negative the child has to be started on phenytoin or phenobarbitone.

13 years ago

H

hemraj soni

0

first thing is to diagnosis of case.........it was probably status epilepticus......so we should confirm diag. before planning discharge......get MRI brain, EEG, CSF if required.......if any parenchymal focus of seizure is there then continue with Valprin as it is better than eptoin ..........

13 years ago

S

Satish Datla

0

PHENYTOIN BUT SHOULD SEE FOR THE CAUSE

13 years ago

Answer 1

Since this child had a status epilepticus, it is better to keep the child on maintenance act for sometime. An EEG and MRI will help to delineate the cause. Continuation of ACT will depend on the cause. If no cause is found, one can try to taper and stop in next 12 months if the child does not have further episodes of seizures.

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