Suggest Treatment For Frequent Urination, Increased Convulsions, ASD And VSD

Posted on Sun, 9 Aug 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 9 Aug 2015 Answered on

Mon, 31 Aug 2015 Last reviewed on

Question : My daughter aged 25 years had congenital heart defect( ASD &VSD). It was corrected when she was 20 months old. 24 hours hours after the surgery she started getting convulsions. She was put on Gardenal. Doctors have tried several drugs like Tegretol, Zeptol, Frisium, Topomac, Levipil, Lacoset, Levera. She was on Zeptol 600CR ,Frisium 10 mg & Levipil 500 mg 1 tablet each morning & evening for a long time. At present she is on Valparin Chrono 500, Frisium 10 mg, & Levipil 500mg, 1 tablet each morning & evening. Her convulsions have increased in number as well as in severity. Moreover after starting Valporin Chrono her fingers have started trembling continuously and there is frequent urination. What should I do? Try some other drug or revert to Zeptol ? Let me know.

Answered by Dr. Neeraj Kumar (7 hours later)

Brief Answer:
Epilepsy due to ischemic injury

Detailed Answer:
Hello XXXXXXX
I have gone through your question and understand your concerns.

Epilepsy in the present setting seems to be associated with brain injury due to congenital heart disease or ischemic injury during perioperative period.
What is the MRI finding and EEG reports?
Dose requirement increases with age as the weight of person increases.
It is necessary to increase the dose of drug to maximum tolerable limit before adding the next one.
In my opinion you should try oxcarbamazepine and lacosamide with frisium. Levipil should be added if adequate dosage of above medications are not controlling seizures.
What is the weight of your daughter?
Surgical options are also there in cases of refractory epilepsy but requires proper treatment trail and preop workup regarding benefit of surgery.

Hope you found the answer helpful.
regards
Dr Neeraj Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj