My daughter is on Phenytoin, but still, she gets seizure. What to do?

Question

Hi doctor,

My daughter is suffering from cerebral palsy of right side since birth. It is also called seizure, hemiplegic type. Now she is 24 years old. Her right side of the body, right leg and right hand are not working properly. She walks with staggers with raised heel part of the right leg and right-hand palm part is totally twisted. She is very peevish and quick angry girl. Sometimes, convulsion occurs during sleep followed by clenched fist of both hands, jammed jaws, twisted and perked body. I treated her well, but no result. Since two months she is complaining severe pain in her right thigh. Presently, I am giving her Eptoin 100 mg three times a day to stop convulsions. Please suggest me some way to get her out of the thigh pain.

Answer 1

Hello,

Welcome to icliniq.com. Your daughter seems to have right hemiplegia and seizures. The way of walking with raised heel and right arm twisted is increased tone in right-sided limbs suggestive of spasticity and contracture. As you told that she is already on Tablet Eptoin (Phenytoin) 100 mg three times daily, still she is having seizures. I assume that she is getting medicines regularly, without skipping. In such condition maybe we need to add second medication for seizure control. I advise you to consult the neurologist for starting second appropriate medicine. If seizure remains resistant to medication, there may be some possibility of brain surgery to reduce the seizures. For that also you need to consult the neurologist in person with all her reports. The second point is the spasticity and contracture in heels. For that, she may require medication for reducing spasticity, Baclofen or injection Botox (Botulinum toxin) or contracture release surgery at right heel.