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What Does The Following MRI Scan Report Indicate?
Question: Dear doctor, my husband had fits at Last month, took a MRI scan, report says calcification white matter less than 1 cm...our doctor suggest Eptoin phenytoin 100mg tablets 2 at night for 6 months. .... is it k.....
Brief Answer:
seems ok...
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your husband had seizure probably Focal-onset seizure with or without secondary generalization as MRI can showed white matter calcification .
Phenytoin(eptoin ) is the drug of choice for Tonic-clonic & Focal-onset seizures.
Adult Dose-3–6 mg/kg/day.Usually it comes to around 300–400 mg/day. 100 mg in the morning and 200 mg at bed-time
It is also to be noted that serum albumin levels decline with ageing so that there is decrease in protein binding of some drugs (e.g. Phenytoin, warfarin) and thereby more of the free (active ) drug is available,hence lower dose 200 mg/day is adequate to control seizure.
However, it is reasonable to continue therapy for 2 years seizure free period before gradual withdrawal.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
seems ok...
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your husband had seizure probably Focal-onset seizure with or without secondary generalization as MRI can showed white matter calcification .
Phenytoin(eptoin ) is the drug of choice for Tonic-clonic & Focal-onset seizures.
Adult Dose-3–6 mg/kg/day.Usually it comes to around 300–400 mg/day. 100 mg in the morning and 200 mg at bed-time
It is also to be noted that serum albumin levels decline with ageing so that there is decrease in protein binding of some drugs (e.g. Phenytoin, warfarin) and thereby more of the free (active ) drug is available,hence lower dose 200 mg/day is adequate to control seizure.
However, it is reasonable to continue therapy for 2 years seizure free period before gradual withdrawal.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Above answer was peer-reviewed by :
Dr. Prasad
Empression in scan report is small speck of calcification less than 1 cm in subcortical white matter of left precentral gyrus. .... It is need to continue tablet for 2 years? My husband age is 26....he got fits at 2min before 2 months ...
Brief Answer:
Follow-up query
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your husband's MRI scan brain shows an underlying structural abnormality that is responsible for the fits.
He had single seizure type, either focal or generalized.
You have not mentioned EEG report.
In view of structural abnormality 2 years seizure free period is imperative before withdrawal of aniconvulsant drug and it is preferable to reduce the dose of the drug gradually over 2–3 months
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Follow-up query
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Your husband's MRI scan brain shows an underlying structural abnormality that is responsible for the fits.
He had single seizure type, either focal or generalized.
You have not mentioned EEG report.
In view of structural abnormality 2 years seizure free period is imperative before withdrawal of aniconvulsant drug and it is preferable to reduce the dose of the drug gradually over 2–3 months
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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