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Suggest Treatment For Severe Abdominal Pain In A Child With Epilepsy

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Posted on Thu, 7 Jul 2016
Question: Sir,my daughter is suffering with epilepsy since March 2011.She was 9 then.She was treated with Sodium valproate.But as her SGPT level becomes higher she was prescribed Oxetol 300 mg twice daily along with Lobazam at night.She is taking Oxetol Since XXXXXXX this year(2016).now since feb her abdominal pain starts .Since then she had to b consulted(general medicine,MD) thrice fr her abdominal pain and on one occasion she had 2 b admitted to hospital.presently she is having acute pain in abdomen and her SGPT is 305 U/L and SGOT 187 U/L.i need to save her .plz taper oxetol and prescribe an alternative drug.
doctor
Answered by Dr. Sudhir Kumar (10 minutes later)
Brief Answer:
Levetiracetam would be safe

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist and would try to help you to the best of my abilities.

Oxetol is generally safe. However, it can be tapered to 150 mg twice daily for five days and then stopped.

Now, we can start Levetiracetam (LEVIPIL), which is very safe for liver. The usual dose is 500 mg two times daily.

I would be pleased to answer any follow-up queries.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (1 hour later)
with LEVIPIL 500 mg twice daily ,lobazam will be continued.the medicines prescribed by the MD(medicine) will continue.I PRESUME.Do u think Sir,Neksium is needed along with levipil and lobazam?& Sir,Is it (Levipil) is going to b started before oxitol is tapered?OR Can i stop oxitol altogether and start Levipil 500mg Right from today?THIS INFORMATION is vry imp fr me.plz opine Sir
doctor
Answered by Dr. Sudhir Kumar (28 minutes later)
Brief Answer:
Levipil and oxetol will overlap for 5 days

Detailed Answer:
Levipil can be started on day 1. Oxetol will overlap for 5 days at 150 mg two times daily. Lobazam can be continued. Nexium is not needed.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (2 hours later)
Sir,as she is having acute pain after taking oxetol ,should i taper it or absolutely withdraw it?this is vry vry imp, Sir
doctor
Answered by Dr. Sudhir Kumar (7 minutes later)
Brief Answer:
It can be stopped under medical supervision.

Detailed Answer:
Thank you for getting back.

Oxetol can be abruptly stopped only under medical supervision, as seizures may occur.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (47 hours later)
She Has Become Irritable & violent.can she be given Tegretal In place of levipil 500 mg.if so ,then what should be the dose?Do u think tegretal will b safe fr her?kindly opine Sir.This is Vry Vry Imp.
doctor
Answered by Dr. Sudhir Kumar (16 minutes later)
Brief Answer:
Tegrital can be safely given

Detailed Answer:
Thank you for getting back.

Yes, she can be safely given Tegrital instead of Levipil. The dose of Tegrital is 10-20 mg per kg body weight, given in two divided doses.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (3 minutes later)
she is 14 years old and her weight is 57 kg.Kindly let us know the doses ,Sir.we r anxiously waiting fr ur reply,Sir.
doctor
Answered by Dr. Sudhir Kumar (8 minutes later)
Brief Answer:
The dose was mentioned in the previous reply.

Detailed Answer:
Thank you for getting back.

As mentioned, for a 57 (nearly 60 kg) patient, the dose would be 60 X 10 = 600 mg per day. As it needs to be given in two divided doses, the dose would be 300 mg in morning and 300 mg at nights. Some people may get dizziness with tegrital, so, for the first five days, I given 150 mg two times daily, and then, make it 300 mg two times daily.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (5 minutes later)
Her SGPT is 305 U/L.she is having acute abdominal pain.She is having hepatomegaly.Sir Is It(TEGRETAL) Safe Fr her?Kindly opine,Sir.
doctor
Answered by Dr. Sudhir Kumar (9 minutes later)
Brief Answer:
What is the cause of her liver disease?

Detailed Answer:
We need to know the cause of abdominal symptoms, hepatomegaly and elevation of SGPT. Then, we can further advise on the safety of tegrital.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 6231 Questions

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Suggest Treatment For Severe Abdominal Pain In A Child With Epilepsy

Brief Answer: Levetiracetam would be safe Detailed Answer: Hi, Thank you for posting your query. I am Dr Sudhir Kumar, Neurologist and would try to help you to the best of my abilities. Oxetol is generally safe. However, it can be tapered to 150 mg twice daily for five days and then stopped. Now, we can start Levetiracetam (LEVIPIL), which is very safe for liver. The usual dose is 500 mg two times daily. I would be pleased to answer any follow-up queries. Best wishes, Dr Sudhir Kumar MD DM (Neurology)