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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Menegioma, Dilantin Level Lowered, Feeling Lightheaded. Advised Surgery, Going Off Dilatin. Suggestion?

Have a menegioma and Dilantin level lowered to 200 mg pm 100 mg am. Down 800 mg per week. Level is 6.7.
Am lightheaded (not dizzy) balance off once in awhile. Is this level to low. Dr. wants to lower lever 100 mg
monthly. Had a grandmal sizure 5 yrs ago. Previous dr. kept my levels between 10 and 20. Lately levels
have been inconsistent 6.7 to 24. Previous dr. would change amt taken to keep it balanced. New dr.
says 6.7 is fine and I should consider surgery. She want me to go off Dilantin totally. I'm 74 yrs old with
fairly good health. By the way... want a excellent neurologist in Menifee/Murrietta/Temecula calif. area
Sat, 28 Sep 2013
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Neurologist 's  Response
Hi,
Thank you for posting your query.

There are two issues here-

1. Whether or not we should do surgery for meningioma?
2. The appropriate dose of dilantin.

Meningioma can only be treated by surgery. There are no medicines to make it disappear. So, if the tumor is large or is in a critical part of brain or it is growing in size, we should do the surgery for meningioma.

The correct dose of dilantin (phenytoin) is 5 mg per kg body weight. So, if your weight is about 60 kg, then, you should be on 300 mg per day- either 100 mg three times daily, or 200 mg pm and 100 mg am.

I hope it helps.

Please get back if you require any additional information.

Best wishes,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad,
My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


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Have Menegioma, Dilantin Level Lowered, Feeling Lightheaded. Advised Surgery, Going Off Dilatin. Suggestion?

Hi, Thank you for posting your query. There are two issues here- 1. Whether or not we should do surgery for meningioma? 2. The appropriate dose of dilantin. Meningioma can only be treated by surgery. There are no medicines to make it disappear. So, if the tumor is large or is in a critical part of brain or it is growing in size, we should do the surgery for meningioma. The correct dose of dilantin (phenytoin) is 5 mg per kg body weight. So, if your weight is about 60 kg, then, you should be on 300 mg per day- either 100 mg three times daily, or 200 mg pm and 100 mg am. I hope it helps. Please get back if you require any additional information. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) Senior Consultant Neurologist Apollo Hospitals, Hyderabad, My personal URL on this website: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/